Provider Demographics
NPI:1871897249
Name:PATEL, ALEXANDRIA S (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:MARIE
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:69 KENNEBEC RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1315
Mailing Address - Country:US
Mailing Address - Phone:207-974-6057
Mailing Address - Fax:
Practice Address - Street 1:157 PARK ST STE 34
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5063
Practice Address - Country:US
Practice Address - Phone:207-974-6057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMF2352106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist