Provider Demographics
NPI:1407266158
Name:SPRAGUE, ALEXANDER THORNDIKE (MA, LPCC)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:THORNDIKE
Last Name:SPRAGUE
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:ZANDER
Other - Middle Name:
Other - Last Name:SPRAGUE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC
Mailing Address - Street 1:10 SEMINARY RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:CA
Mailing Address - Zip Code:94517-1756
Mailing Address - Country:US
Mailing Address - Phone:510-828-8715
Mailing Address - Fax:
Practice Address - Street 1:10 SEMINARY RIDGE PL
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:CA
Practice Address - Zip Code:94517-1756
Practice Address - Country:US
Practice Address - Phone:510-828-8715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-03
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC9543101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health