Provider Demographics
NPI:1215250543
Name:ALEXANDER, LINDEN Y
Entity type:Individual
Prefix:
First Name:LINDEN
Middle Name:Y
Last Name:ALEXANDER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4938 CHANCELLOR ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4222
Mailing Address - Country:US
Mailing Address - Phone:267-250-2600
Mailing Address - Fax:267-250-2600
Practice Address - Street 1:4938 CHANCELLOR ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-4222
Practice Address - Country:US
Practice Address - Phone:267-250-2600
Practice Address - Fax:267-250-2600
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0184331041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical