Provider Demographics
NPI:1588837140
Name:SPENCER, ALEXIS MONIQUE (LAPC)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:MONIQUE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 LAKEWOOD WAY SW
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-6022
Mailing Address - Country:US
Mailing Address - Phone:404-762-3560
Mailing Address - Fax:
Practice Address - Street 1:215 LAKEWOOD WAY SW
Practice Address - Street 2:SUITE 205
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-6022
Practice Address - Country:US
Practice Address - Phone:404-762-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional