Provider Demographics
NPI:1174059075
Name:KILLIPS, ALEXA RAE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:RAE
Last Name:KILLIPS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:RAE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 KIMBALL ST
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-3231
Mailing Address - Country:US
Mailing Address - Phone:906-322-6716
Mailing Address - Fax:
Practice Address - Street 1:1001 KIMBALL ST
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-3231
Practice Address - Country:US
Practice Address - Phone:906-322-6716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker