Healthcare Provider Details

I. General information

NPI: 1497170658
Provider Name (Legal Business Name): ALEXANDER COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 CRATER LAKE AVE
MEDFORD OR
97504-6810
US

IV. Provider business mailing address

514 CRATER LAKE AVE
MEDFORD OR
97504-6810
US

V. Phone/Fax

Practice location:
  • Phone: 541-826-8282
  • Fax: 541-538-5109
Mailing address:
  • Phone: 541-826-8282
  • Fax: 541-538-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR2261
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: RUTHANNE ALEXANDER
Title or Position: EXECUTIVE DIRECTOR
Credential: MS, LPC
Phone: 541-826-8282