Provider Demographics
NPI:1518766716
Name:NELSON, ALEXANDRA DEAR (LMSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:DEAR
Last Name:NELSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 ESSEX ST APT 7D
Mailing Address - Street 2:
Mailing Address - City:DEEP RIVER
Mailing Address - State:CT
Mailing Address - Zip Code:06417-1963
Mailing Address - Country:US
Mailing Address - Phone:203-927-5568
Mailing Address - Fax:
Practice Address - Street 1:67 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5084
Practice Address - Country:US
Practice Address - Phone:860-425-5258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9854104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker