Basic Information
| Provider Information | |||||||||
| NPI: | 1952836660 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEXANDER-SSEBAGALA | ||||||||
| FirstName: | THERESE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 337 ELM ST | ||||||||
| Address2: | |||||||||
| City: | STONINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063782928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606500053 | ||||||||
| FaxNumber: | 5084331871 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 BOSTON POST RD FL 1 | ||||||||
| Address2: | |||||||||
| City: | WATERFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063852401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606500053 | ||||||||
| FaxNumber: | 5084331871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2017 | ||||||||
| LastUpdateDate: | 12/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.