Provider Demographics
NPI:1790063790
Name:HYDE WASHMON, ALEXIS E (BCBA, LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:E
Last Name:HYDE WASHMON
Suffix:
Gender:F
Credentials:BCBA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 VALLEY LANDING DRIVE
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450
Mailing Address - Country:US
Mailing Address - Phone:281-827-8556
Mailing Address - Fax:
Practice Address - Street 1:1503 VALLEY LANDING DRIVE
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:281-827-8556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61752101Y00000X
TX1-07-3550103K00000X
TX200964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist