Provider Demographics
NPI:1073078754
Name:ALEXANDER, SEAN (LCPC, PHD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:LCPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8433 SOUTHSIDE BLVD APT 911
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8473
Mailing Address - Country:US
Mailing Address - Phone:954-465-0398
Mailing Address - Fax:786-257-5650
Practice Address - Street 1:8433 SOUTHSIDE BLVD APT 911
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-8473
Practice Address - Country:US
Practice Address - Phone:954-465-0398
Practice Address - Fax:786-257-5650
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL74086101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral