| Doctor Name: | MR. ALEX R. MADRID |
| NPI Number: | 1134222920 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.P.C. |
| License Number: | 5209 |
| Business Practice Address: | 19900 S Main St Suite 4e Cornelius, NC - 280316512 |
| Business Phone Number: | 7045065944 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1791, DAVIDSON |
| State: | NC |
| Postal Code: | 280361791 |
| Phone Number: | 7045065944 |
| Fax Number: | |
| NPI Enumeration Date: | 09/07/2006 |
| NPI Last Update Date: | 08/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 5209 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |