Individual provider Active NPI

Alexa Dersovitz

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1669399796
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
713 Harrison St
Syracuse, NY 13210-2305
Phone
(315) 464-3145
NPI assigned
Jun 30, 2026
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NY Primary

Addresses

Primary practice location

713 Harrison St
Syracuse, NY 13210-2305

Mailing address

1 Sunshine LN
Livingston, NJ 07039-1128
Phone (973) 307-4107

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

NPI Registry JSON

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

{
    "created_epoch": "1782777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1669399796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SUNSHINE LN",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391128",
            "telephone_number": "973-307-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 HARRISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102305",
            "telephone_number": "315-464-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERSOVITZ",
        "first_name": "ALEXA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.