Provider Demographics
NPI:1568261675
Name:SMITH, ALEXIS ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 JAY ST STE 501
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4398
Mailing Address - Country:US
Mailing Address - Phone:347-304-9465
Mailing Address - Fax:
Practice Address - Street 1:203 JAY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4398
Practice Address - Country:US
Practice Address - Phone:877-670-0162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0950091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical