Provider Demographics
NPI:1982074076
Name:BEAVERS, ALEXANDRA MORGAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:MORGAN
Last Name:BEAVERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:MORGAN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:880 S PLEASANTBURG DR STE 4F
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2453
Mailing Address - Country:US
Mailing Address - Phone:864-660-3525
Mailing Address - Fax:864-751-5177
Practice Address - Street 1:880 S PLEASANTBURG DR STE 4F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-660-3525
Practice Address - Fax:864-751-5177
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC301100Medicaid
SC301100Medicaid