Individual provider Active NPI

Alexandra Christiana Wahlquist, LMSW, CSW-INTERN

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1740992684
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IC-2099 Issued in NV
Practice address
5426 Vegas Dr
Las Vegas, NV 89108-2403
Phone
(702) 806-5268
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X IC-2099 NV Primary

Addresses

Primary practice location

5426 Vegas Dr
Las Vegas, NV 89108-2403

Mailing address

7400 W Flamingo Rd Apt 2075
Las Vegas, NV 89147-4397
Phone (702) 533-3542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IC-2099NVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1740992684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 W FLAMINGO RD APT 2075",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891474397",
            "telephone_number": "702-533-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5426 VEGAS DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891082403",
            "telephone_number": "702-806-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLQUIST",
        "first_name": "ALEXANDRA",
        "middle_name": "CHRISTIANA",
        "credential": "LMSW, CSW-INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-2099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.