Provider Demographics
NPI:1982280277
Name:BIRKLAND, ALEXANDRIA NICOLE (MS)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:NICOLE
Last Name:BIRKLAND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8378 GREEN CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2617
Mailing Address - Country:US
Mailing Address - Phone:702-339-3359
Mailing Address - Fax:
Practice Address - Street 1:7040 LAREDO ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3000
Practice Address - Country:US
Practice Address - Phone:702-331-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI3277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCI3277OtherBOARD OF EXAMINERS FOR MFT AND CPC