Provider Demographics
NPI:1306525506
Name:DAVIES, ALEXANDRIA EDEN (PHD, LCP)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:EDEN
Last Name:DAVIES
Suffix:
Gender:F
Credentials:PHD, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 BAINBRIDGE ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2138
Mailing Address - Country:US
Mailing Address - Phone:704-576-9399
Mailing Address - Fax:
Practice Address - Street 1:1402 BAINBRIDGE ST UNIT B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2138
Practice Address - Country:US
Practice Address - Phone:704-576-9399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008121103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical