Healthcare Provider Details

I. General information

NPI: 1518672229
Provider Name (Legal Business Name): VICTORIA LAUREN ALEXANDER PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N 40TH AVE
HATTIESBURG MS
39401-6606
US

IV. Provider business mailing address

PO BOX 18679
HATTIESBURG MS
39404-8679
US

V. Phone/Fax

Practice location:
  • Phone: 769-390-7929
  • Fax: 769-390-7929
Mailing address:
  • Phone: 601-705-1901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP-1005
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0423
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: