Provider Demographics
NPI:1295079119
Name:KARYDI, ALEXANDRA M (MA, CSAC, CAC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:M
Last Name:KARYDI
Suffix:
Gender:F
Credentials:MA, CSAC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 SHIVERS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-5413
Mailing Address - Country:US
Mailing Address - Phone:803-896-7544
Mailing Address - Fax:803-896-9014
Practice Address - Street 1:1731 SHIVERS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-5413
Practice Address - Country:US
Practice Address - Phone:803-896-7544
Practice Address - Fax:803-896-9014
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1111015101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)