Provider Demographics
NPI:1558675181
Name:ADLER, ALEXIS S (PSYD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:S
Last Name:ADLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6217
Mailing Address - Country:US
Mailing Address - Phone:617-653-0526
Mailing Address - Fax:
Practice Address - Street 1:21 COLEMAN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-6217
Practice Address - Country:US
Practice Address - Phone:617-653-0526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9951103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist