Provider Demographics
NPI:1568893998
Name:GEORGE, ALEXANDRA (LMHC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LMHC, CRC
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:CONTRERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, CRC
Mailing Address - Street 1:1253 ISLAMORADA DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8268
Mailing Address - Country:US
Mailing Address - Phone:561-354-8103
Mailing Address - Fax:
Practice Address - Street 1:1253 ISLAMORADA DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8268
Practice Address - Country:US
Practice Address - Phone:561-354-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11834101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health