Provider Demographics
NPI:1275883001
Name:LEXIE, MIRIAM S (LMHC)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:S
Last Name:LEXIE
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 1:83 BEACON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2454
Mailing Address - Country:US
Mailing Address - Phone:215-828-9835
Mailing Address - Fax:
Practice Address - Street 1:101 WASON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1140
Practice Address - Country:US
Practice Address - Phone:617-426-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12321-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health