Provider Demographics
NPI:1487720272
Name:COY, ALEXANDRA HALL (MED, LMHC)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:HALL
Last Name:COY
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W HOLLY ST STE 324
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4329
Mailing Address - Country:US
Mailing Address - Phone:360-650-1591
Mailing Address - Fax:360-734-4946
Practice Address - Street 1:203 W HOLLY ST STE 324
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4329
Practice Address - Country:US
Practice Address - Phone:360-650-1591
Practice Address - Fax:360-734-4946
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5164637OtherAETNA ID NUMBER
WA14658OtherREGENCE ID NUMBER