Provider Demographics
NPI:1972137909
Name:KOHNEN, ALEXANDRA ELISABETH (LPC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ELISABETH
Last Name:KOHNEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:ELISABETH
Other - Last Name:DECLUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 COMMUNITY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-8804
Mailing Address - Country:US
Mailing Address - Phone:660-885-8131
Mailing Address - Fax:
Practice Address - Street 1:102 COMPASS POINT DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-4404
Practice Address - Country:US
Practice Address - Phone:844-853-8937
Practice Address - Fax:636-528-2123
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019039112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional