Provider Demographics
NPI:1679854335
Name:ALEXIS, ANDREA (LPCC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:ALEXIS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:ALEXIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:1070 UPHAM DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210
Mailing Address - Country:US
Mailing Address - Phone:614-366-0909
Mailing Address - Fax:614-293-4504
Practice Address - Street 1:1070 UPHAM DRIVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-366-0909
Practice Address - Fax:614-293-4504
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-700175101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional