Provider Demographics
NPI:1336502194
Name:HARWOOD, ALYSSA FENNER (LPCC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:FENNER
Last Name:HARWOOD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:FENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:178 PRIVATE DR. 19423
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-8831
Mailing Address - Country:US
Mailing Address - Phone:740-313-0040
Mailing Address - Fax:740-894-1132
Practice Address - Street 1:178 PRIVATE DR. 19423
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-8831
Practice Address - Country:US
Practice Address - Phone:740-313-0040
Practice Address - Fax:740-894-1132
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1400294101Y00000X
OHE.2001788101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor