Basic Information
| Provider Information | |||||||||
| NPI: | 1700516317 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARRA | ||||||||
| FirstName: | ALEXANDRA | ||||||||
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| Credential: | PCMSW, PLMHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3068 S 60TH ST APT 28 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681064348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8439014360 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1941 S 42ND ST STE 328 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681052943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026148444 | ||||||||
| FaxNumber: | 4026148443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2022 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 7731 | NE | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 12986 | NE | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.