Healthcare Provider Details

I. General information

NPI: 1770467631
Provider Name (Legal Business Name): ALEXANDRA PAIGE MCCRARY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11315 CORPORATE BLVD BUILDING 500 SUITE 105
ORLANDO FL
32817
US

IV. Provider business mailing address

3304 BISHOP PARK DR APT 811
WINTER PARK FL
32792-2869
US

V. Phone/Fax

Practice location:
  • Phone: 407-534-0186
  • Fax:
Mailing address:
  • Phone: 561-704-2182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: