Provider Demographics
NPI:1750733069
Name:ALEXANDER, CHAD (MA, LPC)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 CHARLEVOIX RD STE 304
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8423
Mailing Address - Country:US
Mailing Address - Phone:231-838-7837
Mailing Address - Fax:
Practice Address - Street 1:3890 CHARLEVOIX RD STE 306
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8423
Practice Address - Country:US
Practice Address - Phone:231-838-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional