Alexandra Tique-Montenegro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

431 E State Highway 114 FL 1
Southlake, TX 76092-4412

Phone

(844) 824-8775

NPI assigned

Jan 31, 2007

Last updated

Dec 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alexandra Tique Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1902943939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 BEVERLY HILLS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761141756",
            "telephone_number": "817-625-4254",
            "fax_number": "817-378-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E STATE HIGHWAY 114 FL 1",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924412",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140-15 B Sanford Ave",
            "address_2": "2nd floor",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "11355",
            "country_code": "US",
            "telephone_number": "718-358-8288 x208",
            "fax_number": "718-358-5264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2332 Beverly Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761141756",
            "country_code": "US",
            "telephone_number": "817-625-4254",
            "fax_number": "817-378-0861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIQUE-MONTENEGRO",
        "first_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "TIQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Southlake, TX
• Providers in Southlake, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.