Provider Demographics
NPI:1528857364
Name:TOWNSEND, ALEX JEROME (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:JEROME
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3452 TUTTLEGROVE RD
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-8702
Mailing Address - Country:US
Mailing Address - Phone:609-724-8654
Mailing Address - Fax:
Practice Address - Street 1:2 SPLIT ROCK DR STE 11
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1244
Practice Address - Country:US
Practice Address - Phone:856-428-1260
Practice Address - Fax:856-428-2313
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15325700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health