Provider Demographics
NPI:1972912756
Name:DOLIN, ALEXANDER (LPCC-S)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:DOLIN
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 BRICE RD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3403
Mailing Address - Country:US
Mailing Address - Phone:614-239-9965
Mailing Address - Fax:614-515-4716
Practice Address - Street 1:1900 BRICE RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3403
Practice Address - Country:US
Practice Address - Phone:614-239-9965
Practice Address - Fax:614-515-4716
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.161759101YA0400X
OHE.1800664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0289779Medicaid