Provider Demographics
NPI:1770366551
Name:MCMAHAN, ALEXA COLE (LPC)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:COLE
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 ENGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-3807
Mailing Address - Country:US
Mailing Address - Phone:941-706-5822
Mailing Address - Fax:
Practice Address - Street 1:3918 CLOCK POINTE TRL STE 104
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2989
Practice Address - Country:US
Practice Address - Phone:216-896-0735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2305386101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor