MEDICARE: CHARLES E. ALEXANDER M.DIV., TH.M.

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	102	AL
2	106H00000X	Marriage & Family Therapist	087	AL

General Provider Information

NPI Number	:	1790992436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES E. ALEXANDER M.DIV., TH.M.

Provider Business Mailing Address
First Line	:	160 MOHICAN DR
Second Line	:
City	:	PELL CITY
State	:	AL
Zip	:	35128-7123
Country	:	US
Telephone Number	:	205-884-6952
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 ALFORD AVE
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35226-3127
Country	:	US
Telephone Number	:	205-824-8320
Fax Number	:

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	09/11/2025

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