Provider Demographics
NPI:1598540601
Name:THERAPY WITH ALIX
Entity Type:Organization
Organization Name:THERAPY WITH ALIX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCADC
Authorized Official - Phone:859-267-7141
Mailing Address - Street 1:108 LORRAINE CT
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1318
Mailing Address - Country:US
Mailing Address - Phone:859-267-7141
Mailing Address - Fax:
Practice Address - Street 1:210 N BROADWAY ST STE 1
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-2212
Practice Address - Country:US
Practice Address - Phone:859-267-7141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty