Provider Demographics
NPI:1386352102
Name:FORSYTH, ALEXANDRA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:FORSYTH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:CAVE SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72718-8809
Mailing Address - Country:US
Mailing Address - Phone:479-847-2042
Mailing Address - Fax:
Practice Address - Street 1:504 SUNSET DR
Practice Address - Street 2:
Practice Address - City:CAVE SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72718-8809
Practice Address - Country:US
Practice Address - Phone:479-847-2042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY242246103TC0700X
AR202296103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical