Provider Demographics
NPI:1760897920
Name:GOLDMAN, ALEXIS (LPCC)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2202
Mailing Address - Country:US
Mailing Address - Phone:502-585-9444
Mailing Address - Fax:502-585-9466
Practice Address - Street 1:214 BRECKENRIDGE LN STE 114
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3868
Practice Address - Country:US
Practice Address - Phone:502-653-7211
Practice Address - Fax:502-416-0723
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1888101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional