Provider Demographics
NPI:1538273768
Name:OSTERMAN, ALEXANDRA H (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:H
Last Name:OSTERMAN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:H
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:925 CONWAY RD
Mailing Address - Street 2:
Mailing Address - City:ASHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01330-9772
Mailing Address - Country:US
Mailing Address - Phone:413-774-6252
Mailing Address - Fax:413-773-0477
Practice Address - Street 1:25 BANK ROW ST
Practice Address - Street 2:FL 3
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3599
Practice Address - Country:US
Practice Address - Phone:413-774-6252
Practice Address - Fax:413-773-0477
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111-3231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P23079Medicare ID - Type Unspecified