Healthcare Provider Details

I. General information

NPI: 1114129327
Provider Name (Legal Business Name): ALEXANDRA M. PRICE PSY.D., ABPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 06/10/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THRIVEWORKS 5372 DISCOVERY PARK BLVD, SUITE 204
WILLIAMSBURG VA
23188
US

IV. Provider business mailing address

113 FALL E
WILLIAMSBURG VA
23188-1635
US

V. Phone/Fax

Practice location:
  • Phone: 617-379-0496
  • Fax:
Mailing address:
  • Phone: 757-814-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810003891
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0810003891
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: