DOUGLAS L ALEXANDER M.ED, LISAC, NPI 1932207222 — CASA GRANDE (AZ)

NPI 1932207222

13+ Years Experience Individual

DOUGLAS L ALEXANDER M.ED, LISAC

09/20/2006
PROVIDER ENUMERATION DATE
10/19/2009
LAST UPDATE DATE
1932207222
NPI NUMBER

About DOUGLAS L ALEXANDER

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

DOUGLAS L ALEXANDER is a provider established in CASA GRANDE, AZ. The NPI number of DOUGLAS L ALEXANDER is 1932207222 and was assigned on 09/20/2006. The practitioners primary taxonomy code is: 101YA0400X with license number: 10680 AZ .

Mailing address

  • City: MESA
  • State: AZ
  • Postal code: 852026463
  • Phone: 6026190071
  • Address: 2155 W KIVA AVE

Primary Practice Address

  • Region : CASA GRANDE, AZ
  • NPI : 1932207222
  • Phone : 5207239800
  • Fax : 5207233260
  • Postalcode : 852227423
  • Address : 5497 W MCCARTNEY RD

Additional identifiers

  • Identifier: 10680
  • Code / Type : 1 - other
  • Identifier state : AZ
  • Identifier issuer: LISAC

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 105362
  • Code / Type : 5 - MEDICAID
  • Identifier state : AZ

Provider taxonomy - Counselor

  • Taxonomy code: 101YA0400X
  • License number: 10680
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Healthcare provider taxonomy #2 - Counselor

  • Taxonomy code: 101YM0800X
  • License number: 10680
  • License state: AZ

The taxonomy is not the primary taxonomy.

Contacts:

Click to Show Map
  • DOUGLAS L ALEXANDER M.ED, LISAC
  • Address : 5497 W MCCARTNEY RD
  • Region : CASA GRANDE, AZ
  • NPI : 1932207222
  • Phone : 5207239800
  • Fax : 5207233260
  • Postalcode : 852227423

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address5497 W MCCARTNEY RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCASA GRANDE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code852227423
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number5207239800
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number5207233260
The fax number associated with the location address of the provider being identified.
NPI1932207222
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1101YA0400X
Provider Enumeration Date09/20/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10/19/2009
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DOUGLAS L ALEXANDER
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address2155 W KIVA AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameMESA
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code852026463
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6026190071
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1101YA0400X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Counselor
Provider License Number 110680
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1AZ
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2101YM0800X
Healthcare Provider Taxonomy 2Counselor
Provider License Number 210680
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2AZ
Healthcare Provider Primary Taxonomy Switch 2N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 110680
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1AZ
Other Provider Identifier State #1
Other Provider Identifier Issuer 1LISAC
Other Provider Identifier Issuer #1
Other Provider Identifier 2105362
Other Provider Identifier #2
Other Provider Identifier Type 25
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2AZ
Other Provider Identifier State #2
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

Share this page?