1396101739 NPI number — MRS. ALEXANDREA ELMORE LESNOFF LCSWA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396101739 NPI number — MRS. ALEXANDREA ELMORE LESNOFF LCSWA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LESNOFF
Provider First Name:
ALEXANDREA
Provider Middle Name:
ELMORE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSWA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ELMORE
Provider Other First Name:
ALEXANDREA
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSWA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396101739
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
284 EXECUTIVE PARK DR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28025-1833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-939-1100
Provider Business Mailing Address Fax Number:
704-939-1173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5841 US 421 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LILLINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27546-6713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-893-5727
Provider Business Practice Location Address Fax Number:
910-893-6404
Provider Enumeration Date:
01/14/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  P009902 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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