Provider Demographics
NPI:1982141883
Name:YUNDT, ALEXANDER (LPC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:YUNDT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W SILVER SPRING DR STE K200
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5052
Mailing Address - Country:US
Mailing Address - Phone:414-207-4415
Mailing Address - Fax:
Practice Address - Street 1:500 W SILVER SPRING DR STE K200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-5052
Practice Address - Country:US
Practice Address - Phone:414-207-4415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7190-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health