Provider Demographics
NPI:1255676995
Name:ALEXANDER, CYNTHIA ELVA (LCAS-A,MA,MA)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ELVA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCAS-A,MA,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 GOFORTH DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8502
Mailing Address - Country:US
Mailing Address - Phone:910-527-0285
Mailing Address - Fax:910-429-9032
Practice Address - Street 1:3828 GOFORTH DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-8502
Practice Address - Country:US
Practice Address - Phone:910-527-0285
Practice Address - Fax:910-429-9032
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2738-A101YA0400X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No302R00000XManaged Care OrganizationsHealth Maintenance Organization