Provider Demographics
NPI:1669088001
Name:DOYLE, ALEXANDRA (MS, LAC, NCC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MS, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BRIARTWIST LN
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2238
Mailing Address - Country:US
Mailing Address - Phone:732-476-9688
Mailing Address - Fax:
Practice Address - Street 1:1500 ROUTE 88
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2320
Practice Address - Country:US
Practice Address - Phone:732-785-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJAC-GTL-20-01738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029807Medicaid