Provider Demographics
NPI:1861870248
Name:ALEXANDER, ELIZABETH A (LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 RUBY LN
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-1082
Mailing Address - Country:US
Mailing Address - Phone:419-733-0507
Mailing Address - Fax:
Practice Address - Street 1:1170 OLD HENDERSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3623
Practice Address - Country:US
Practice Address - Phone:419-733-0507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1300622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health