Provider Demographics
NPI:1528777380
Name:SCALLION, ALEXANDRA (LMHC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:SCALLION
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 NW 150TH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2888
Mailing Address - Country:US
Mailing Address - Phone:954-431-9838
Mailing Address - Fax:954-241-6726
Practice Address - Street 1:7320 GRIFFIN RD STE 101
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4105
Practice Address - Country:US
Practice Address - Phone:954-300-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH21543OtherSTATE LICENSE