Provider Demographics
NPI:1396384764
Name:ORRICK, ALIXANDREA ANNE (LCPC)
Entity Type:Individual
Prefix:
First Name:ALIXANDREA
Middle Name:ANNE
Last Name:ORRICK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:ALIXANDREA
Other - Middle Name:ANNE
Other - Last Name:RENDEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16864 BLUEJACKET ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-7629
Mailing Address - Country:US
Mailing Address - Phone:913-626-9521
Mailing Address - Fax:816-221-9121
Practice Address - Street 1:12541 FOSTER ST STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2307
Practice Address - Country:US
Practice Address - Phone:913-327-7505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health