Provider Demographics
NPI:1922815570
Name:DOEDE, ALEC (LPC/MHSP)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:DOEDE
Suffix:
Gender:M
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 GOLANVYI TRL
Mailing Address - Street 2:
Mailing Address - City:VONORE
Mailing Address - State:TN
Mailing Address - Zip Code:37885-2647
Mailing Address - Country:US
Mailing Address - Phone:865-229-6570
Mailing Address - Fax:
Practice Address - Street 1:402 GREENBELT DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5702
Practice Address - Country:US
Practice Address - Phone:865-338-5384
Practice Address - Fax:865-338-5383
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional