Provider Demographics
NPI:1306242052
Name:ALEXANDER, PAUL BRETT (LPC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:BRETT
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5088 REMER RD
Mailing Address - Street 2:
Mailing Address - City:CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054-2709
Mailing Address - Country:US
Mailing Address - Phone:810-740-6069
Mailing Address - Fax:
Practice Address - Street 1:5088 REMER RD
Practice Address - Street 2:
Practice Address - City:CHINA
Practice Address - State:MI
Practice Address - Zip Code:48054-2709
Practice Address - Country:US
Practice Address - Phone:810-740-6069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011278101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional