Individual provider Active NPI

Alexandra Ingram, PHD

  • Clinical Psychologist
  • Beaufort, SC
National Provider Identifier
1679283113
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1794 Issued in SC
Practice address
1706 Westview Ave
Beaufort, SC 29902-3753
Phone
(843) 575-3139
NPI assigned
Nov 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1794 SC Primary

Addresses

Primary practice location

1706 Westview Ave
Beaufort, SC 29902-3753

Mailing address

1706 Westview Ave
Beaufort, SC 29902-3753
Phone (843) 575-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230331001316 SC Practitioner - Clinical Psychologist 4880069020 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Group, LLC CurrentSince Jun 1, 2024 Accepting new patients
House of the Guardian, LLC Clinical Current Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Mar 17, 2023 Accepting new patients
Lifesource of North Carolina CurrentSince Mar 17, 2023 Accepting new patients

Locations

20 Towne Dr
Bluffton, SC 29910
Phone (843) 441-9208

1555 Fording Island Rd
Ste C1
Hilton Head Island, SC 29926
Phone (843) 815-6789

1915 Ebenezer Rd
Rock Hill, SC 29732
Phone (305) 866-9951

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1679283113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 WESTVIEW AVE",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299023753",
            "telephone_number": "843-575-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 WESTVIEW AVE",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299023753",
            "telephone_number": "843-575-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "ALEXANDRA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.