Healthcare Provider Details

I. General information

NPI: 1477514974
Provider Name (Legal Business Name): CYNTHIA L ALEXANDER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2006
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 ADAMS AVE
GRAND HAVEN MI
49417-1089
US

IV. Provider business mailing address

505 ADAMS AVE
GRAND HAVEN MI
49417-1089
US

V. Phone/Fax

Practice location:
  • Phone: 954-790-0797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY6248
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019227
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: