Provider Demographics
NPI:1609553239
Name:CLARY-SANCHEZ, ALYSSA MICHELLE (LPCA)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MICHELLE
Last Name:CLARY-SANCHEZ
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 TOWNEPARK WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2303
Mailing Address - Country:US
Mailing Address - Phone:502-254-9555
Mailing Address - Fax:
Practice Address - Street 1:12730 TOWNEPARK WAY STE 201
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2303
Practice Address - Country:US
Practice Address - Phone:502-254-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY280879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional