Provider Demographics
NPI:1821694191
Name:NOLL, ALEXANDRA ENGLE (LCMHC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ENGLE
Last Name:NOLL
Suffix:
Gender:F
Credentials:LCMHC ASSOCIATE
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:LAUREN
Other - Last Name:ENGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 ANSLEY WALK LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-5731
Mailing Address - Country:US
Mailing Address - Phone:734-476-7964
Mailing Address - Fax:
Practice Address - Street 1:107 ANSLEY WALK LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-5731
Practice Address - Country:US
Practice Address - Phone:734-476-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health