Basic Information
| Provider Information | |||||||||
| NPI: | 1255989638 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOOLFE | ||||||||
| FirstName: | ALEXANDRA | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1028 BERME RD | ||||||||
| Address2: | |||||||||
| City: | HIGH FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124405529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148263996 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 FAMILY PRACTICE DR | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124016449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453382562 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2019 | ||||||||
| LastUpdateDate: | 10/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 010521 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.