Provider Demographics
NPI:1528690575
Name:MOSES, ALEXANDRA SHIRES (LMSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:SHIRES
Last Name:MOSES
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 1:37 W 26TH ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1006
Mailing Address - Country:US
Mailing Address - Phone:703-380-0504
Mailing Address - Fax:929-273-7849
Practice Address - Street 1:37 W 26TH ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1006
Practice Address - Country:US
Practice Address - Phone:703-380-0504
Practice Address - Fax:929-273-7849
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2024-10-15
Deactivation Date:2024-10-01
Deactivation Code:
Reactivation Date:2024-10-15
Provider Licenses
StateLicense IDTaxonomies
NY108350104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker