Provider Demographics
NPI:1033727276
Name:CERVANTES, ALEJANDRO (LCSW, DSW)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:CERVANTES
Suffix:
Gender:M
Credentials:LCSW, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 27TH AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5509
Mailing Address - Country:US
Mailing Address - Phone:631-861-4567
Mailing Address - Fax:
Practice Address - Street 1:233 BROADWAY STE 2360
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10279-0001
Practice Address - Country:US
Practice Address - Phone:917-814-2116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108883104100000X
NY0972131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker