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General NPI Number Information
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NPI Number | 1164950077
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Entity Type | Individual
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Provider Name | ALEJANDRA ISABEL MEDINA MA, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 130 HAMPTON CIR STE 130
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4113
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Country | US
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Telephone | 248-840-3376
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Fax | 248-841-4714
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Provider Business Mailing Address
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Address Line | 2665 BELLE VIEW DR
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City | SHELBY TWP
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State | MI
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Zip | 48316-2930
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Country | US
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Telephone | 248-840-3376
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Fax | 248-841-4714
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401014391
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License Number State | MI
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