Provider Demographics
NPI:1194283762
Name:VIZCARRA, ALEXA BRITTANY (LPC)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:BRITTANY
Last Name:VIZCARRA
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 1:38 ALLISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWFOUNDLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07435-1400
Mailing Address - Country:US
Mailing Address - Phone:845-702-0272
Mailing Address - Fax:
Practice Address - Street 1:259 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2528
Practice Address - Country:US
Practice Address - Phone:908-914-2624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-03
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00785600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health