Provider Demographics
NPI:1235903741
Name:FORD, ALEXIS SHERNITA (LMHC)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SHERNITA
Last Name:FORD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 OAKFIELD DR UNIT 290
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5707
Mailing Address - Country:US
Mailing Address - Phone:813-378-0393
Mailing Address - Fax:
Practice Address - Street 1:208 OAKFIELD DR UNIT 290
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5707
Practice Address - Country:US
Practice Address - Phone:813-378-0393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health