Healthcare Provider Details

I. General information

NPI: 1205757408
Provider Name (Legal Business Name): ALEXANDRA FLORENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 E 23RD ST
KANSAS CITY MO
64127-3701
US

IV. Provider business mailing address

5513 NE 58TH ST
KANSAS CITY MO
64119-2401
US

V. Phone/Fax

Practice location:
  • Phone: 844-424-3577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05460
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: