Provider Demographics
NPI:1730403510
Name:MASTRANGELO, ALEXANDRA (LMHC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:MASTRANGELO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 LOWELL ST STE B7
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3073
Mailing Address - Country:US
Mailing Address - Phone:781-367-8387
Mailing Address - Fax:
Practice Address - Street 1:226 LOWELL ST STE B7
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-3073
Practice Address - Country:US
Practice Address - Phone:781-367-8387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS65053041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7493OtherMASSACHUSETTS ALLIED HEALTH MENTAL HEALTH COUNSELOR