Provider Demographics
NPI:1528733151
Name:ALEXA WERNICK PSYCHOTHERAPY LCSW PLLC
Entity type:Organization
Organization Name:ALEXA WERNICK PSYCHOTHERAPY LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXA
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-460-4499
Mailing Address - Street 1:1806 PINE HILL DR
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5224
Mailing Address - Country:US
Mailing Address - Phone:727-460-4499
Mailing Address - Fax:
Practice Address - Street 1:150 E 18TH ST APT 11K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2458
Practice Address - Country:US
Practice Address - Phone:727-460-4499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health