Alexandra Lytle O'Brien, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW19435 Issued in FL

Practice address

4540 Lafayette St
Marianna, FL 32446

Phone

(850) 942-2000

NPI assigned

Mar 21, 2022

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 21, 2022.

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1154070993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 BUENA VISTA DRIVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32304",
            "telephone_number": "407-406-1256",
            "fax_number": "850-942-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 LAFAYETTE ST",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "32446",
            "telephone_number": "850-942-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ALEXANDRA",
        "middle_name": "LYTLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Florida Eye Institute PA
• North Florida Family Healthcare
• Northwest Florida Healthcare, Inc.
• Madison Grace Nowell
• Michael P Nuccio, PA
• Raul Philip Olazabal, MD
• Sofia Denise Olds
• Kari Oliver, PHARMD
• Reagan Eliza Oliver
• Tara L Oswald, LMHC

• All providers in Marianna, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.