Provider Demographics
NPI:1821320961
Name:ALEXANDER, LOIS (MSW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 E BELTLINE AVE SE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7630
Mailing Address - Country:US
Mailing Address - Phone:616-942-1904
Mailing Address - Fax:616-942-1904
Practice Address - Street 1:2025 E BELTLINE AVE SE
Practice Address - Street 2:SUITE 204
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7630
Practice Address - Country:US
Practice Address - Phone:616-942-1904
Practice Address - Fax:616-942-1904
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-30
Last Update Date:2010-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010015231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical