Blondine Alexandre, LCSW-C
Individual provider Active NPI Social Worker · Bowie, MD
NPI 1629499413 · NPPES record last updated Oct 5, 2021
Key facts
- NPI
- 1629499413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 16313 (MD)
- Practice address
- 14300 Gallant Fox LN Ste 107
Bowie, MD 20715-4031 - Phone
- (202) 830-4320
- NPI assigned
- Dec 20, 2013
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC50081199 | DC | MD | Clinical Social Worker |
| 16313 | MD | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 16313 | MD | |
| Social Worker | 104100000X | 16313 | MD | Yes |
| Clinical Social Worker | 1041C0700X | LC50081199 | DC | |
| Clinical Social Worker | 1041C0700X | 0904011115 | VA |
Addresses
Primary practice location
14300 Gallant Fox LN Ste 107
Bowie, MD 20715-4031
Mailing address
915 Green St Apt 2
Alexandria, VA 22314-4046
Phone (301) 728-0371
Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2021. 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.