Provider Demographics
NPI:1659987667
Name:LANNOM, ALEXIS (LISW)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:LANNOM
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7280 NORTHWIND CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-1084
Mailing Address - Country:US
Mailing Address - Phone:440-789-3055
Mailing Address - Fax:
Practice Address - Street 1:7280 NORTHWIND CT
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-1084
Practice Address - Country:US
Practice Address - Phone:440-789-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker