Individual provider Active NPI

Alexandria Leigh Dougherty

  • Psychiatric/Mental Health Nurse Practitioner
  • Horsham, PA
National Provider Identifier
1962773499
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401443-1 Issued in NY
Practice address
721 Dresher Rd Ste 120
Horsham, PA 19044-2220
Phone
(215) 254-6000
Fax
(215) 754-1705
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401443-1 NY Primary

Addresses

Primary practice location

721 Dresher Rd Ste 120
Horsham, PA 19044-2220

Mailing address

715 Twining Rd Ste 120
Dresher, PA 19025-1832
Phone (215) 254-6000

Other practice location 1

1626 Locust St
Philadelphia, PA 19103-6305
Phone (215) 550-1726

Other practice location 2

795 E Lancaster Ave Ste 1100
Villanova, PA 19085-1500
Phone (215) 254-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191226001557 PA Practitioner - Nurse Practitioner 3779917802 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F401443-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMC of PA PC CurrentSince Oct 27, 2022 Accepting new patients
Complete Mind Care Brain Wellness PLLC CurrentSince Feb 23, 2025 Accepting new patients
Complete Mind Care of PA, LLC PastSince Jan 1, 2023 Accepting new patients
CMC of PA PC PastSince Dec 17, 2023 Accepting new patients

Locations

1021 Old York Rd
Ste 301
Abington, PA 19001
Phone (215) 254-6000

715 Twining Rd
Ste 120
Dresher, PA 19025

721 Dresher Rd
Ste 1100
Horsham, PA 19044
Phone (215) 254-6000

721 Dresher Rd
Ste 120
Horsham, PA 19044
Phone (215) 254-6000

795 E Lancaster Ave
Ste 250
Villanova, PA 19085
Phone (215) 254-6000

795 E Lancaster Ave
Ste 1100
Villanova, PA 19085
Phone (215) 254-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1962773499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 TWINING RD STE 120",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "190251832",
            "telephone_number": "215-254-6000",
            "fax_number": "215-754-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 DRESHER RD STE 120",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442220",
            "telephone_number": "215-254-6000",
            "fax_number": "215-754-1705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1626 Locust St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191036305",
            "country_code": "US",
            "telephone_number": "215-550-1726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "795 E Lancaster Ave Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Villanova",
            "state": "PA",
            "postal_code": "190851500",
            "country_code": "US",
            "telephone_number": "215-254-6000",
            "fax_number": "215-754-1705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "ALEXANDRIA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401443-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

Verify at the official NPI Registry.