Provider Demographics
NPI:1528690575
Name:ANDREW, ALEXANDRA MOSES (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:MOSES
Last Name:ANDREW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ALEXANDRA
Other - Middle Name:SHIRES
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:93 KINGSLAND AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-5757
Mailing Address - Country:US
Mailing Address - Phone:703-380-0504
Mailing Address - Fax:
Practice Address - Street 1:93 KINGSLAND AVE APT 3F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-5757
Practice Address - Country:US
Practice Address - Phone:703-380-0504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2025-08-08
Deactivation Date:2024-10-01
Deactivation Code:
Reactivation Date:2024-10-15
Provider Licenses
StateLicense IDTaxonomies
NY108350104100000X
NY0987791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker