Provider Demographics
NPI:1730402884
Name:ALEXANDER, DARLENE KATRINA (LCPC,NCC,MA)
Entity type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:KATRINA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCPC,NCC,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16547 OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1752
Mailing Address - Country:US
Mailing Address - Phone:708-633-9003
Mailing Address - Fax:708-633-1823
Practice Address - Street 1:16547 OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1752
Practice Address - Country:US
Practice Address - Phone:708-633-9003
Practice Address - Fax:708-633-1823
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional