Provider Demographics
NPI:1154996767
Name:BURCHART, ALEXANDRIA HOPE
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:HOPE
Last Name:BURCHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2928 S 158TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1971
Mailing Address - Country:US
Mailing Address - Phone:402-889-0779
Mailing Address - Fax:
Practice Address - Street 1:4545 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3232
Practice Address - Country:US
Practice Address - Phone:402-553-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12615104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker