Provider Demographics
NPI:1821455346
Name:ALEXANDER, LUCINDA MARIE (BA, CDP)
Entity Type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:MARIE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:BA, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-1118
Mailing Address - Country:US
Mailing Address - Phone:360-423-2806
Mailing Address - Fax:
Practice Address - Street 1:404 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-1118
Practice Address - Country:US
Practice Address - Phone:360-423-2806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60494203101YA0400X
WACP60494203101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)