Provider Demographics
NPI:1225649403
Name:BECHARD, ALEXIS EVELYN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:EVELYN
Last Name:BECHARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 US OVAL STE 100
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12903-5901
Mailing Address - Country:US
Mailing Address - Phone:518-563-8206
Mailing Address - Fax:
Practice Address - Street 1:1490 ROUTE 9N
Practice Address - Street 2:
Practice Address - City:CLINTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12924-4218
Practice Address - Country:US
Practice Address - Phone:518-578-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP105993104100000X
NY1124011041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker