Provider Demographics
NPI:1477514974
Name:ALEXANDER, CYNTHIA L (PSYD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1089
Mailing Address - Country:US
Mailing Address - Phone:954-790-0797
Mailing Address - Fax:877-794-3529
Practice Address - Street 1:10 FERRY ST STE 313
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5004
Practice Address - Country:US
Practice Address - Phone:860-788-6404
Practice Address - Fax:877-794-3529
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6248103T00000X
NH1657103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP36899Medicare UPIN
FLE5934ZMedicare ID - Type Unspecified