Provider Demographics
NPI:1790328920
Name:KRUEGER, ALEXANDER OLIVER (LPC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:OLIVER
Last Name:KRUEGER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8325 MEADOW RD APT 119
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3714
Mailing Address - Country:US
Mailing Address - Phone:817-517-8537
Mailing Address - Fax:
Practice Address - Street 1:8100 LOMO ALTO DR STE 238
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6545
Practice Address - Country:US
Practice Address - Phone:214-981-4918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79353101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor