Provider Demographics
NPI:1730525247
Name:FIELD, ALEXANDRA KATHERINE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:KATHERINE
Last Name:FIELD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 A C SKINNER PKWY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6954
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:904-348-2818
Practice Address - Street 1:7011 A C SKINNER PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6954
Practice Address - Country:US
Practice Address - Phone:804-310-8957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0092111041C0700X
FLSW 136521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical