Provider Demographics
NPI:1093692758
Name:ALEXANDER, SHIRLEY ANN (LSW)
Entity type:Individual
Prefix:
First Name:SHIRLEY ANN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 LA FRANCE AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5651
Mailing Address - Country:US
Mailing Address - Phone:973-842-1988
Mailing Address - Fax:
Practice Address - Street 1:570 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1308
Practice Address - Country:US
Practice Address - Phone:973-450-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05484600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health