Provider Demographics
NPI:1932715109
Name:BUCHWALD, ALEXANDRA LEIA (LICSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LEIA
Last Name:BUCHWALD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 LINCOLN ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-1635
Mailing Address - Country:US
Mailing Address - Phone:831-419-8765
Mailing Address - Fax:
Practice Address - Street 1:33 BOSTON POST RD W
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1867
Practice Address - Country:US
Practice Address - Phone:508-824-3673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MALICSW11208091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health