Alexandra Subbaraman, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28554 Issued in MN

Practice address

6625 Lyndale Ave S Ste 440
Richfield, MN 55423-2380

Phone

(612) 712-7200

NPI assigned

Jul 28, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anubhava Mental Health LLC

  • Clinical Social Worker
  • Okemos, MI
  • NPI 1528740263
  NPD Authorized official
• 3C Hansons

  • Mental Health Counselor
  • Richfield, MN
  • NPI 1780221887
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1124637988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498410040",
            "telephone_number": "989-941-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 440",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232380",
            "telephone_number": "612-712-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Xerxes Ave N",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554112851",
            "country_code": "US",
            "telephone_number": "763-521-3477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBBARAMAN",
        "first_name": "ALEXANDRA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stonebridge Wellness LTD
• Carol J Strand, LMFT
• Katharine Marcia Straub
• Kathryn Strobel
• Anna R Strupp
• Ilhan Mohamed Sufi
• Michael Joseph Sullivan, AU.D.
• Sulyn Transportation LLC
• Supplying Seniors LLC
• Adam Sasha Angelina Sutliff

• Clinical Social Worker in Richfield, MN
• Providers in Richfield, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.