Provider Demographics
NPI:1316322605
Name:WALKER, ALEXSANDRA KYLIE (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXSANDRA
Middle Name:KYLIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CEDARBIRD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-8560
Mailing Address - Country:US
Mailing Address - Phone:646-820-4673
Mailing Address - Fax:
Practice Address - Street 1:1501 CEDARBIRD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-8560
Practice Address - Country:US
Practice Address - Phone:646-820-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX518261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical