Alexa Jane Lee Sutherland, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9806 Issued in CT

Practice address

300 Church St
Yalesville, CT 06492-2253

Phone

(203) 679-0849

NPI assigned

Jun 27, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Alexa Lee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1871014100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 KEITH CIR",
            "city": "KILLINGWORTH",
            "state": "CT",
            "postal_code": "064191453",
            "telephone_number": "203-215-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "064922253",
            "telephone_number": "203-679-0849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 American Legion Hwy",
            "address_purpose": "LOCATION",
            "city": "Roslindale",
            "state": "MA",
            "postal_code": "021313908",
            "country_code": "US",
            "telephone_number": "203-215-0253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "ALEXA",
        "middle_name": "JANE LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXA",
            "last_name": "LEE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Yalesville, CT
• Providers in Yalesville, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.