Provider Demographics
NPI:1760718225
Name:BIRNIE, ALEXANDRA LEE (LMHC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LEE
Last Name:BIRNIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 NEW STATE HWY
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1433
Mailing Address - Country:US
Mailing Address - Phone:508-880-6868
Mailing Address - Fax:
Practice Address - Street 1:90 NEW STATE HWY
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1433
Practice Address - Country:US
Practice Address - Phone:508-880-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health