Provider Demographics
NPI:1376883066
Name:IOANNIDES, ALEXIA CHRISTIANA (LMHC, LPC, R-DMT)
Entity type:Individual
Prefix:MISS
First Name:ALEXIA
Middle Name:CHRISTIANA
Last Name:IOANNIDES
Suffix:
Gender:F
Credentials:LMHC, LPC, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4752 STORKWOOD WAY APT A
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4194
Mailing Address - Country:US
Mailing Address - Phone:561-989-4307
Mailing Address - Fax:
Practice Address - Street 1:4752 STORKWOOD WAY APT A
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4194
Practice Address - Country:US
Practice Address - Phone:561-989-4307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019356101YP2500X
FLMH10559101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional