Provider Demographics
NPI: | 1720408289 |
---|---|
Name: | ALEXY COUNSELING PRACTICE LLC |
Entity type: | Organization |
Organization Name: | ALEXY COUNSELING PRACTICE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | JUDY |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | ALEXY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 412-656-7078 |
Mailing Address - Street 1: | 2961 W LIBERTY AVE |
Mailing Address - Street 2: | SUITE 212 |
Mailing Address - City: | PITTSBURGH |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15216-2546 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 412-343-6044 |
Mailing Address - Fax: | 412-561-5937 |
Practice Address - Street 1: | 2961 W LIBERTY AVE |
Practice Address - Street 2: | SUITE 212 |
Practice Address - City: | PITTSBURGH |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15216-2546 |
Practice Address - Country: | US |
Practice Address - Phone: | 412-343-6044 |
Practice Address - Fax: | 412-561-5937 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-04-23 |
Last Update Date: | 2014-05-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |