Provider Demographics
NPI:1316674716
Name:ALEXANDER, BRANDY KATHERINE (BCBA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:KATHERINE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 W WAVELAND AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4175
Mailing Address - Country:US
Mailing Address - Phone:760-644-5751
Mailing Address - Fax:
Practice Address - Street 1:875 N MICHIGAN AVE FL 31
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1962
Practice Address - Country:US
Practice Address - Phone:833-599-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2025-08-21
Deactivation Date:2025-06-06
Deactivation Code:
Reactivation Date:2025-08-05
Provider Licenses
StateLicense IDTaxonomies
IL152.002712103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty