Provider Demographics
NPI:1396495073
Name:HARRELL, ALEXANDRA CINDA (MA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:CINDA
Last Name:HARRELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 WILLOCKS DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-4122
Mailing Address - Country:US
Mailing Address - Phone:865-335-4006
Mailing Address - Fax:
Practice Address - Street 1:200 MIDLAKE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-3089
Practice Address - Country:US
Practice Address - Phone:865-335-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health