Provider Demographics
NPI:1881954956
Name:TRUSTY, ALEXANDRA L (MS NCC LAC)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:L
Last Name:TRUSTY
Suffix:
Gender:F
Credentials:MS NCC LAC
Other - Prefix:MRS
Other - First Name:ALEXANDRA
Other - Middle Name:L
Other - Last Name:SILER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS NCC LAC
Mailing Address - Street 1:2108 E THOMAS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-0008
Mailing Address - Country:US
Mailing Address - Phone:602-933-3124
Mailing Address - Fax:
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18313101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health