Provider Demographics
NPI:1104429687
Name:KENNEDY, ALEXANDRA FINCH (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:FINCH
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:ALLY
Other - Middle Name:
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11306 CHURCHILL WAY CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4152
Mailing Address - Country:US
Mailing Address - Phone:713-206-2414
Mailing Address - Fax:
Practice Address - Street 1:2060 NORTH LOOP W STE 205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8146
Practice Address - Country:US
Practice Address - Phone:832-900-0279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81618101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional