Provider Demographics
NPI:1174965362
Name:HAGLER, ALEXANDRIA ELNORA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:ELNORA
Last Name:HAGLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:ELNORA
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:22152 HART ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2323
Mailing Address - Country:US
Mailing Address - Phone:818-422-2864
Mailing Address - Fax:
Practice Address - Street 1:22152 HART ST
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2323
Practice Address - Country:US
Practice Address - Phone:818-422-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA761121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36505OtherBBS ACSW REGISTRATION NUMBER