Provider Demographics
NPI:1407381379
Name:HOLDEFER, ALEXANDRA (LCSW, CADC)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:HOLDEFER
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 165TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5660
Mailing Address - Country:US
Mailing Address - Phone:708-307-4950
Mailing Address - Fax:
Practice Address - Street 1:9601 165TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5660
Practice Address - Country:US
Practice Address - Phone:708-307-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0188681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical