Provider Demographics
NPI:1700013901
Name:GREY, ALEXANDRIA O (LCPC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:O
Last Name:GREY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5758 RHODE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-3826
Mailing Address - Country:US
Mailing Address - Phone:703-670-6477
Mailing Address - Fax:
Practice Address - Street 1:12407 LUNDALE CT
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-6129
Practice Address - Country:US
Practice Address - Phone:703-586-3225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional