Alexandra Sallese Devin, LCAT
Individual provider Active NPI Drama Therapist · Beacon, NY
NPI 1619385705 · NPPES record last updated Mar 29, 2023
Key facts
- NPI
- 1619385705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Drama Therapist 101200000X
- License
- 001794-01 (NY)
- Practice address
- 55 Sycamore Dr
Beacon, NY 12508-3929 - Phone
- (347) 730-7356
- NPI assigned
- Aug 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001794-01 | NY | MD | Drama Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Drama Therapist | 101200000X | 001794-01 | NY | Yes |
Addresses
Primary practice location
55 Sycamore Dr
Beacon, NY 12508-3929
Mailing address
55 Sycamore Dr
Beacon, NY 12508-3929
Phone (347) 730-7356
Other names
- Ms. Alexandra Devin Vicich
Other providers in Beacon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.