MEDICARE: JESSIE BETH ALEXANDER LPC

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	101YP2500X	Professional Counselor		GA

General Provider Information

NPI Number	:	1306569199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSIE BETH ALEXANDER LPC

Provider Business Mailing Address
First Line	:	2651 MERCEDES DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3974
Country	:	US
Telephone Number	:	470-606-4277
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 SEMINOLE AVE NE STE 107
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30307-3411
Country	:	US
Telephone Number	:	470-632-1250
Fax Number	:

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

Provider Enumeration Date	:	09/26/2022
Last Update Date	:	09/26/2022

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Directions to “ JESSIE BETH ALEXANDER LPC” Practice Location

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