Provider Demographics
NPI:1578394383
Name:ALEJANDRO, NATHALIE (LAC, LAMFT)
Entity type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:ALEJANDRO
Suffix:
Gender:F
Credentials:LAC, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10259 W PICCADILLY RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-1405
Mailing Address - Country:US
Mailing Address - Phone:623-986-5575
Mailing Address - Fax:
Practice Address - Street 1:4625 S ASH AVE STE J-2
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6761
Practice Address - Country:US
Practice Address - Phone:480-722-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145294101YM0800X
CA15956101YM0800X
AZLAMFT-11007106H00000X
AZLAC-23389101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist