Provider Demographics
NPI:1255560058
Name:HOUSE, ALEXANDRA J (LPC)
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:J
Last Name:HOUSE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43527
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85080-3527
Mailing Address - Country:US
Mailing Address - Phone:602-859-5550
Mailing Address - Fax:
Practice Address - Street 1:34406 N 27TH DR STE 140
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-6079
Practice Address - Country:US
Practice Address - Phone:602-859-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC16029101YP2500X
AZLPC-5508T101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional