MEDICARE: JOSHUA ALEXANDER M.S, MFT-I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	1995	TN

General Provider Information

NPI Number	:	1154015105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA ALEXANDER M.S, MFT-I

Provider Business Mailing Address
First Line	:	580 17TH ST NW APT 11
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-4300
Country	:	US
Telephone Number	:	615-712-1653
Fax Number	:

Provider Business Practice Location Address
First Line	:	393 BROAD ST NW STE 201
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-5039
Country	:	US
Telephone Number	:	423-380-9043
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/05/2023

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