Provider Demographics
NPI:1760289508
Name:ALEXANDER, SOMICA
Entity type:Individual
Prefix:
First Name:SOMICA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 PLUM LEAF LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4513
Mailing Address - Country:US
Mailing Address - Phone:419-344-8584
Mailing Address - Fax:
Practice Address - Street 1:220 FASSETT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-3112
Practice Address - Country:US
Practice Address - Phone:419-724-0004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No175T00000XOther Service ProvidersPeer Specialist
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health