Provider Demographics
NPI:1962115824
Name:ALEXANDER, CONTRELL TERRELL
Entity type:Individual
Prefix:
First Name:CONTRELL
Middle Name:TERRELL
Last Name:ALEXANDER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CONTRELL
Other - Middle Name:
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 251970
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225
Mailing Address - Country:US
Mailing Address - Phone:501-666-8686
Mailing Address - Fax:501-660-6830
Practice Address - Street 1:6601 WEST 12TH. STREET
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1513
Practice Address - Country:US
Practice Address - Phone:501-666-8686
Practice Address - Fax:501-660-6829
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor