Widner Alexandre, LADC I
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Boston, MA
NPI 1962278960 · NPPES record last updated Nov 30, 2023
Key facts
- NPI
- 1962278960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 23160 (MA)
- Practice address
- 263 Eustis St
Boston, MA 02119-2826 - Phone
- (617) 445-1123
- NPI assigned
- Nov 30, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23160 | MA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Belonging Medical Group PLLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| Casa Esperanza, Inc. | Past |
Accepting new patients |
Locations
1900 W Park Dr
Ste 280
Westborough, MA 01581
Phone (508) 983-1425
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23160 | MA | Yes |
Addresses
Primary practice location
263 Eustis St
Boston, MA 02119-2826
Mailing address
133 Addison St
Brockton, MA 02301-1403
Phone (857) 236-8190
Other providers in Boston, MA
- Peta-Maree Ann Alexander
- Richard E. Alexander
- Stephen I Alexander
- Sydney Alexander
- Alexandra Strack, LLC
- Sanda Alexandrescu
- Claire C Alexanian
- Sara M. Alexanian
- Mara Katherine Alexeev
- Margalie M Alexis
All providers in Boston, MA · Addiction (Substance Use Disorder) Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.