Provider Demographics
NPI:1316453343
Name:VARELA, ALEXANDRA DANAE (PHD, LPC, ACS, NCC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:DANAE
Last Name:VARELA
Suffix:
Gender:F
Credentials:PHD, LPC, ACS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 SYCAMORE ST # 5033
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-1026
Mailing Address - Country:US
Mailing Address - Phone:504-237-5991
Mailing Address - Fax:
Practice Address - Street 1:2225 SYCAMORE ST # 5033
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-1026
Practice Address - Country:US
Practice Address - Phone:504-237-5991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional