Provider Demographics
NPI:1053898353
Name:RENFROE, ALECSANDRA SINCLAIR (MS, NCC)
Entity type:Individual
Prefix:
First Name:ALECSANDRA
Middle Name:SINCLAIR
Last Name:RENFROE
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 SW 174TH AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003-4392
Mailing Address - Country:US
Mailing Address - Phone:630-336-5729
Mailing Address - Fax:
Practice Address - Street 1:1440 SW 174TH AVE APT 204
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003-4392
Practice Address - Country:US
Practice Address - Phone:630-336-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health