Alexandra L Vitale, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

076-393-01 Issued in NY

Practice address

353 Martha Ave
Bellport, NY 11713-1524

Phone

(631) 286-6703

NPI assigned

Mar 9, 2009

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

Other names 1

• Alexandra Vitale Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Town of Islip

  • Addiction (Substance Use Disorder) Counselor
  • Islip, NY
  • NPI 1548369143
  NPD (past)
• Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Brockton, MA
  • NPI 1992521512
  NPD (past)

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1750522561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 MARTHA AVE",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131524",
            "telephone_number": "631-286-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 MARTHA AVE",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131524",
            "telephone_number": "631-286-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "ALEXANDRA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076-393-01",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076393",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "VITALE",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• TSR Rehab Services Inc.
• Alyssa Vastano
• Hannah Patrice Vega, RN
• Kimberly Kay Vertichio, D.D.S.
• Anne M. Virgilio, L.C.S.W.
• Scott William Wade, LPN
• Crystal Walker, LCSW
• Camille Watson, LCSW
• Ashley Nicole Weiler, M.S. CCC-SLP
• Kerri Wilson, LPN

• Clinical Social Worker in Bellport, NY
• Providers in Bellport, 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 May 11, 2021; 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.