Healthcare Provider Details

I. General information

NPI: 1376473777
Provider Name (Legal Business Name): ALEXANDRA AGOSTA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3713 PIERCE ST UNIT 101
WHEAT RIDGE CO
80033-6314
US

IV. Provider business mailing address

3713 PIERCE ST UNIT 101
WHEAT RIDGE CO
80033-6314
US

V. Phone/Fax

Practice location:
  • Phone: 484-678-3354
  • Fax:
Mailing address:
  • Phone: 484-678-3354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0021872
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: