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General NPI Number Information
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NPI Number | 1326536111
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Entity Type | Individual
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Provider Name | ALEXI RADFORD LCPC
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Gender | Female
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 1637 W WINONA ST APT 1
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City | CHICAGO
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State | IL
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Zip | 60640-0891
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Country | US
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Telephone | 419-944-1847
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Fax |
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Provider Business Mailing Address
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Address Line | 4630 N BEACON ST APT 1G
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City | CHICAGO
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State | IL
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Zip | 60640-2994
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Country | US
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Telephone |
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Fax |
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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 | 180.013073
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License Number State | IL
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