Provider Demographics
NPI:1225602501
Name:DRAGINIS, ALEXANDRIA R (LPC-IT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:R
Last Name:DRAGINIS
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 N FRATNEY ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2221
Mailing Address - Country:US
Mailing Address - Phone:608-658-4525
Mailing Address - Fax:
Practice Address - Street 1:1530 S 170TH ST
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-1328
Practice Address - Country:US
Practice Address - Phone:414-779-7971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4952-226103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling