Provider Demographics
NPI:1205069788
Name:ALEXANDER, SHEA S (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:SHEA
Middle Name:S
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 TEDDINGTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5924
Mailing Address - Country:US
Mailing Address - Phone:214-697-5557
Mailing Address - Fax:
Practice Address - Street 1:2809 REGAL RD
Practice Address - Street 2:SUITE # 110
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6317
Practice Address - Country:US
Practice Address - Phone:214-697-5557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional