Alexandria Wiedenbaum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

101665 Issued in NY

Practice address

200 Great Oaks Blvd Ste 215
Albany, NY 12203-5969

Phone

(518) 218-1188

Fax

(518) 218-1988

NPI assigned

Mar 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Interborough Developmental and Consultation Center, Inc.

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment
• Albany Psychological Services for Eating Disorders, PLLC

  • Psychologist
  • Albany, NY
  • NPI 1235479387
  NPD (past)

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1306547609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 WASHINGTON AVENUE EXT STE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122036326",
            "telephone_number": "518-218-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREAT OAKS BLVD STE 215",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035969",
            "telephone_number": "518-218-1188",
            "fax_number": "518-218-1988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Bell Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113612097",
            "country_code": "US",
            "telephone_number": "718-504-9256 x49256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEDENBAUM",
        "first_name": "ALEXANDRIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "115494",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Wicks
• Makenzie K Wicks, MS, CCC-SLP
• Alicia Maren Wiczulis, M.D.
• Nicolle Wiebracht, MD
• Lyndsey A. Wieczerza, PNP
• Xenia Lynn Wieland, RN
• Gretchen Herbert Wilber, PSY.D.
• Dorothy Marie Wilbur
• Harry J Wilbur, MD
• Linda Wilcox, RN

• Clinical Social Worker in Albany, NY
• Providers in Albany, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.