Provider Demographics
NPI:1588456222
Name:STEPANENKO, ALEXANDRA (LSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:STEPANENKO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ALEKS
Other - Middle Name:
Other - Last Name:STEPANENKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:136 S DUTOIT ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2214
Mailing Address - Country:US
Mailing Address - Phone:919-768-2626
Mailing Address - Fax:
Practice Address - Street 1:136 S DUTOIT ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2214
Practice Address - Country:US
Practice Address - Phone:919-768-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2512197104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker