Provider Demographics
NPI:1114580842
Name:MEYER, ALEXIS (LPC-MH, LAC, QMHP)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:LPC-MH, LAC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S SYCAMORE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3711
Mailing Address - Country:US
Mailing Address - Phone:605-202-2420
Mailing Address - Fax:
Practice Address - Street 1:1500 S SYCAMORE AVE STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-3711
Practice Address - Country:US
Practice Address - Phone:605-202-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD20511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health