Basic Information
| Provider Information | |||||||||
| NPI: | 1558032748 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW, CASAC-T | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 ELGAR PL APT 25G | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104755039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143207481 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 150 HUGUENOT ST | ||||||||
| Address2: | |||||||||
| City: | NEW ROCHELLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108015204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146130700 | ||||||||
| FaxNumber: | 9146365231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2021 | ||||||||
| LastUpdateDate: | 09/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 105435-01 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.