Provider Demographics
NPI:1841941291
Name:NORTH, ALEX L (LCPC)
Entity type:Individual
Prefix:MISS
First Name:ALEX
Middle Name:L
Last Name:NORTH
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8639 N PARKS RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-9022
Mailing Address - Country:US
Mailing Address - Phone:208-201-8782
Mailing Address - Fax:
Practice Address - Street 1:204 10TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3832
Practice Address - Country:US
Practice Address - Phone:208-466-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-7058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional