Provider Demographics
NPI:1508082074
Name:ALEXANDER, HYTER REZELL (LMSW)
Entity Type:Individual
Prefix:MR
First Name:HYTER
Middle Name:REZELL
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 LEE STREET
Mailing Address - Street 2:
Mailing Address - City:EARLE
Mailing Address - State:AR
Mailing Address - Zip Code:72331
Mailing Address - Country:US
Mailing Address - Phone:870-792-7769
Mailing Address - Fax:870-792-7561
Practice Address - Street 1:320 LEE STREET
Practice Address - Street 2:
Practice Address - City:EARLE
Practice Address - State:AR
Practice Address - Zip Code:72331
Practice Address - Country:US
Practice Address - Phone:870-792-7769
Practice Address - Fax:870-792-7561
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN81661041C0700X, 101YM0800X
TN101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN8166OtherBOARD OF SOCIAL WORK LICENSURE
AR0000OtherARKANSAS SOCIAL WORK LICENSING BOARD