Provider Demographics
NPI:1144629122
Name:CORRADO, ALEXANDRA GARFUNKEL (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:GARFUNKEL
Last Name:CORRADO
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:SASHA
Other - Middle Name:GARFUNKEL
Other - Last Name:CORRADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:227 CHELMSFORD ST STE C
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2305
Mailing Address - Country:US
Mailing Address - Phone:781-801-8493
Mailing Address - Fax:
Practice Address - Street 1:227 CHELMSFORD ST STE C
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2305
Practice Address - Country:US
Practice Address - Phone:781-801-8493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical