Provider Demographics
NPI:1730856295
Name:ALEXANDER, LESLI JORDAN
Entity type:Individual
Prefix:
First Name:LESLI
Middle Name:JORDAN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5074 AMES AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-2323
Mailing Address - Country:US
Mailing Address - Phone:531-355-3025
Mailing Address - Fax:531-355-7150
Practice Address - Street 1:5074 AMES AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2323
Practice Address - Country:US
Practice Address - Phone:531-355-3025
Practice Address - Fax:531-355-7150
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7443101Y00000X
NE121081041C0700X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical