Provider Demographics
NPI:1508351321
Name:ALEXANDER, OLIVIA C (MA, LPC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:C
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S HERITAGE ST
Mailing Address - Street 2:
Mailing Address - City:BELGIUM
Mailing Address - State:WI
Mailing Address - Zip Code:53004-9581
Mailing Address - Country:US
Mailing Address - Phone:262-346-1593
Mailing Address - Fax:
Practice Address - Street 1:1511 BARTON AVE
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-1901
Practice Address - Country:US
Practice Address - Phone:262-346-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional