Provider Demographics
NPI:1730270604
Name:ALEXANDER, KATHLEEN (LMFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 VALLEY WEST DR STE 408
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1942
Mailing Address - Country:US
Mailing Address - Phone:515-421-4508
Mailing Address - Fax:515-225-7546
Practice Address - Street 1:1200 VALLEY WEST DR STE 408
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1942
Practice Address - Country:US
Practice Address - Phone:515-421-4508
Practice Address - Fax:515-225-7546
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1198382Medicaid