Provider Demographics
NPI:1477345429
Name:ALEXANDER, COLEEN (LGPC)
Entity type:Individual
Prefix:
First Name:COLEEN
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5457 TWIN KNOLLS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3296
Mailing Address - Country:US
Mailing Address - Phone:240-475-6715
Mailing Address - Fax:
Practice Address - Street 1:5457 TWIN KNOLLS RD STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3296
Practice Address - Country:US
Practice Address - Phone:240-363-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14288101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional