Provider Demographics
NPI:1689497604
Name:ALEXANDER, STEVIE RHEA
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:RHEA
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19083 COUNTY ROAD 1533
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-0096
Mailing Address - Country:US
Mailing Address - Phone:580-320-2958
Mailing Address - Fax:
Practice Address - Street 1:14430 NORTH SOUTH 3500 ROAD
Practice Address - Street 2:
Practice Address - City:KONAWA
Practice Address - State:OK
Practice Address - Zip Code:74849
Practice Address - Country:US
Practice Address - Phone:580-925-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)