Provider Demographics
NPI:1932295722
Name:MARTELL, ALEXANDRA L (MSW)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:L
Last Name:MARTELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DEARBORN AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3408
Mailing Address - Country:US
Mailing Address - Phone:978-232-0188
Mailing Address - Fax:
Practice Address - Street 1:16 DEARBORN AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3408
Practice Address - Country:US
Practice Address - Phone:978-471-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1115951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical