Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexandria Wiedenbaum, LCSW

Individual provider Social Worker · NPI 1306547609

Alexandria Wiedenbaum, LCSW is a Clinical Social Worker in Albany, New York. Qualified in 2025, 1 year ago. Works from 2 locations. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2023
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

200 Great Oaks Blvd Ste 215
Albany, NY 12203-5969
Phone: (518) 218-1188
Fax: (518) 218-1988
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3635 Bell Blvd Ste 203, Bayside, NY 11361-2097 — (718) 504-9256

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 101665 (NY)
Social Worker Taxonomy 104100000X · Licence 115494 (NY)

Record details

NPI number1306547609
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 14, 2023
Last updated in NPPESDecember 8, 2025
Certification dateDecember 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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