Alexandra L Marin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.019433 Issued in IL

Practice address

2132 W Roscoe St
Chicago, IL 60618-6241

Phone

(310) 384-3322

NPI assigned

Mar 6, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bloom Wellness LLC

  dba Mind Body Family

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1063136968
  NPD Authorized official

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1750707394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2132 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2132 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186241",
            "telephone_number": "310-384-3322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11059 E Bethany Dr",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800142622",
            "country_code": "US",
            "telephone_number": "303-617-2635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIN",
        "first_name": "ALEXANDRA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariel Gardiner Psychotherapy, PLLC
• Alia Ruby Mariella, MS CCC-SLP
• Marienda Nutrition LLC
• Brigid M. Marietta, APRN
• Marigold Psychotherapy PLLC
• Dajana Marin, RD
• Jonathan J Marin
• Lorell Marin, DT, MST
• Mara Clare Marin, LPC
• Maximo James Marin Jr., M.D.

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.