Provider Demographics
NPI:1124691506
Name:KERR, ALEXANDRIA ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:ROSE
Last Name:KERR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11640 ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:AR
Mailing Address - Zip Code:72947-8809
Mailing Address - Country:US
Mailing Address - Phone:479-883-9468
Mailing Address - Fax:479-255-4172
Practice Address - Street 1:11640 ROCK CREEK RD
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:AR
Practice Address - Zip Code:72947-8809
Practice Address - Country:US
Practice Address - Phone:479-515-8700
Practice Address - Fax:479-255-4172
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10106-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical