Healthcare Provider Details

I. General information

NPI: 1659815744
Provider Name (Legal Business Name): ALEXANDRIA CARROLL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE STE N
SPOKANE WA
99201-0581
US

IV. Provider business mailing address

1198 LERWICK CT
SUNNYVALE CA
94087-5011
US

V. Phone/Fax

Practice location:
  • Phone: 509-508-1504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61379937
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: