Provider Demographics
NPI:1730623976
Name:MCGINNIS, ALEXANDRA SHEA (LCAS, LCSWA, CSI)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:SHEA
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:LCAS, LCSWA, CSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 YORKTOWN DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-3247
Mailing Address - Country:US
Mailing Address - Phone:828-209-8625
Mailing Address - Fax:828-544-1201
Practice Address - Street 1:602 YORKTOWN DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-3247
Practice Address - Country:US
Practice Address - Phone:828-209-8625
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0148561041C0700X
NC26540101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical