MEDICARE: ALEXA COLE MCMAHAN 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	101Y00000X	Counselor	C.2305386	OH

General Provider Information

NPI Number	:	1770366551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA COLE MCMAHAN LPC

Provider Business Mailing Address
First Line	:	3029 ENGLEWOOD DR
Second Line	:
City	:	STOW
State	:	OH
Zip	:	44224-3807
Country	:	US
Telephone Number	:	941-706-5822
Fax Number	:

Provider Business Practice Location Address
First Line	:	3918 CLOCK POINTE TRL STE 104
Second Line	:
City	:	STOW
State	:	OH
Zip	:	44224-2989
Country	:	US
Telephone Number	:	216-896-0735
Fax Number	:

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

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	08/16/2023

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