Provider Demographics
NPI:1548385636
Name:ALEXANDER, LYNDA (MA,BA,CCS,LCAS)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MA,BA,CCS,LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:LAKEVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28350-0190
Mailing Address - Country:US
Mailing Address - Phone:910-245-4339
Mailing Address - Fax:910-845-4799
Practice Address - Street 1:285 CAMP EASTER ROAD
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:NC
Practice Address - Zip Code:28350
Practice Address - Country:US
Practice Address - Phone:910-245-4339
Practice Address - Fax:910-245-4799
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC442101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6110554Medicaid