Provider Demographics
NPI:1750447975
Name:ALEXANDER, MYRNA B (EDD, LPC,LMFT,NCC,)
Entity Type:Individual
Prefix:DR
First Name:MYRNA
Middle Name:B
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:EDD, LPC,LMFT,NCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 9TH RD S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4169
Mailing Address - Country:US
Mailing Address - Phone:703-979-5159
Mailing Address - Fax:703-979-4811
Practice Address - Street 1:5276 DAWES AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1404
Practice Address - Country:US
Practice Address - Phone:703-379-7350
Practice Address - Fax:703-379-7352
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001005101YP2500X
DCPRC 44101YP2500X
VA0717000085106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5413931Medicaid