Provider Demographics
NPI:1730544560
Name:PENALBERT, ALEXSANDRA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ALEXSANDRA
Middle Name:
Last Name:PENALBERT
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 1:5 ELLSWORTH AVE
Mailing Address - Street 2:APT. A
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5952
Mailing Address - Country:US
Mailing Address - Phone:203-788-0062
Mailing Address - Fax:
Practice Address - Street 1:969 W MAIN ST STE 2G
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2666
Practice Address - Country:US
Practice Address - Phone:203-936-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT93111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical