Provider Demographics
NPI:1790142370
Name:BURROW, ALEXIS RAE (LPCC-S)
Entity Type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:RAE
Last Name:BURROW
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:MS
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:RAE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC-S
Mailing Address - Street 1:3535 FISHINGER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-2000
Mailing Address - Country:US
Mailing Address - Phone:513-543-9207
Mailing Address - Fax:
Practice Address - Street 1:3535 FISHINGER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026
Practice Address - Country:US
Practice Address - Phone:513-543-9207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0602053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional