Provider Demographics
NPI:1699026971
Name:BECKWITH, ALEXANDRA NICOLE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4922
Mailing Address - Country:US
Mailing Address - Phone:919-488-0015
Mailing Address - Fax:919-277-0066
Practice Address - Street 1:270 HORIZON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4922
Practice Address - Country:US
Practice Address - Phone:919-488-0015
Practice Address - Fax:919-277-0066
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9008101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6115101Medicaid