Active NPI
Alexandra Lytle O'Brien, LCSW
- Clinical Social Worker
- Marianna, FL
National Provider Identifier
1154070993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW19435
- Practice address
- 4540 Lafayette St
Marianna, FL 32446 - Phone
- (850) 942-2000
- NPI assigned
- Mar 21, 2022
- Last updated
- Mar 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW19435 | FL | Primary |
Addresses
Primary practice location
4540 Lafayette St
Marianna, FL 32446
Mailing address
811 Buena Vista Drive
Tallahassee, FL 32304
Phone (407) 406-1256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW19435 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"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": []
}Other providers in Marianna, FL
Sources for this page
- 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.