Provider Demographics
NPI:1841791134
Name:ALEXANDER, WILLIE W (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIE
Middle Name:W
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 MONKHOUSE DR STE 116
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71109-6123
Mailing Address - Country:US
Mailing Address - Phone:318-670-7461
Mailing Address - Fax:318-670-7908
Practice Address - Street 1:4615 MONKHOUSE DR STE 116
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71109-6123
Practice Address - Country:US
Practice Address - Phone:318-670-7461
Practice Address - Fax:318-670-7908
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health