MEDICARE: DR. ALEXANDER EDWARD CHAN PH.D., LMFT

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	398	AL

General Provider Information

NPI Number	:	1760897516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER EDWARD CHAN PH.D., LMFT

Provider Business Mailing Address
First Line	:	5039 CONNECTICUT AVE NW STE 5
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2056
Country	:	US
Telephone Number	:	202-237-1196
Fax Number	:

Provider Business Practice Location Address
First Line	:	5039 CONNECTICUT AVE NW STE 5
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2056
Country	:	US
Telephone Number	:	202-237-1196
Fax Number	:

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

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	04/22/2019

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