Provider Demographics
NPI:1578269437
Name:ALEXANDER, JENNIFER MARIE (LGPC, MA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LGPC, MA
Other - Prefix:
Other - First Name:JEN
Other - Middle Name:
Other - Last Name:ALEXANDER-SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1940 3RD ST NE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1459
Mailing Address - Country:US
Mailing Address - Phone:515-450-1916
Mailing Address - Fax:
Practice Address - Street 1:316 F ST NE STE 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4934
Practice Address - Country:US
Practice Address - Phone:202-930-2748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC200001478101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1205482130OtherCAREFIRST