Provider Demographics
NPI:1801364716
Name:ALEXA JOY COUNSELING, LLC
Entity Type:Organization
Organization Name:ALEXA JOY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:BERGERON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:854-732-0632
Mailing Address - Street 1:2439 BROADWAY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-4108
Mailing Address - Country:US
Mailing Address - Phone:954-732-0632
Mailing Address - Fax:
Practice Address - Street 1:2439 BROADWAY ST STE 203
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-4108
Practice Address - Country:US
Practice Address - Phone:954-732-0632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty