Provider Demographics
NPI:1609217504
Name:CULKEEN, ALEXANDRIA FRANCES (BA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:FRANCES
Last Name:CULKEEN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2930
Mailing Address - Country:US
Mailing Address - Phone:978-210-6269
Mailing Address - Fax:
Practice Address - Street 1:112 MARKET ST FL 2
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1125
Practice Address - Country:US
Practice Address - Phone:781-592-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS80064808101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor