Provider Demographics
NPI:1003968108
Name:ALEXANDER, BEVERLY LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:LYNN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 W SLAUGHTER LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5711
Mailing Address - Country:US
Mailing Address - Phone:512-851-2225
Mailing Address - Fax:512-851-2226
Practice Address - Street 1:3407 W SLAUGHTER LN
Practice Address - Street 2:SUITE A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5711
Practice Address - Country:US
Practice Address - Phone:512-851-2225
Practice Address - Fax:512-851-2226
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24439103TC0700X, 103T00000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy