Provider Demographics
NPI:1356535710
Name:ALEXANDRA A LONC PA
Entity type:Organization
Organization Name:ALEXANDRA A LONC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LONC
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CAP, CST, CFAE
Authorized Official - Phone:954-540-6335
Mailing Address - Street 1:1300 E HILLSBORO BLVD
Mailing Address - Street 2:201
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4235
Mailing Address - Country:US
Mailing Address - Phone:954-540-6335
Mailing Address - Fax:954-429-8338
Practice Address - Street 1:1300 E HILLSBORO BLVD
Practice Address - Street 2:201
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4235
Practice Address - Country:US
Practice Address - Phone:954-540-6335
Practice Address - Fax:954-429-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 71261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty