Provider Demographics
NPI:1467103663
Name:CARSON, ALEXANDRA STEWART (RMHC)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:STEWART
Last Name:CARSON
Suffix:
Gender:F
Credentials:RMHC
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:STEWART
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RMHC
Mailing Address - Street 1:183 HIDDEN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-5874
Mailing Address - Country:US
Mailing Address - Phone:404-895-8359
Mailing Address - Fax:
Practice Address - Street 1:415 S HYDE PARK AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2268
Practice Address - Country:US
Practice Address - Phone:813-254-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17599101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional