Provider Demographics
NPI:1215594411
Name:ENRIGHT, ALEXIS (IMFT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ENRIGHT
Suffix:
Gender:F
Credentials:IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-0094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:843 N CLEVELAND MASSILLON RD STE 6
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2184
Practice Address - Country:US
Practice Address - Phone:330-723-7977
Practice Address - Fax:330-725-5177
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF.1900091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist