Provider Demographics
NPI:1003184987
Name:ALEXANDER, MARI ANTOINETTE (PHD, LPC-MHSP)
Entity type:Individual
Prefix:DR
First Name:MARI
Middle Name:ANTOINETTE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PHD, LPC-MHSP
Other - Prefix:DR
Other - First Name:MARI
Other - Middle Name:ANTOINETTE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC-MHSP
Mailing Address - Street 1:2805 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-1605
Mailing Address - Country:US
Mailing Address - Phone:615-400-2504
Mailing Address - Fax:615-447-1065
Practice Address - Street 1:2805 RIVER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-1605
Practice Address - Country:US
Practice Address - Phone:617-777-6594
Practice Address - Fax:617-221-3260
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2768101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)