Provider Demographics
NPI:1174334569
Name:ALEXANDRE, LUGMIE
Entity type:Individual
Prefix:
First Name:LUGMIE
Middle Name:
Last Name:ALEXANDRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BUSHKILL
Mailing Address - State:PA
Mailing Address - Zip Code:18324-8205
Mailing Address - Country:US
Mailing Address - Phone:973-349-6851
Mailing Address - Fax:
Practice Address - Street 1:66 SUNSET STRIP STE 302
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1362
Practice Address - Country:US
Practice Address - Phone:862-707-2469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00845300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health