Provider Demographics
NPI:1013272897
Name:BARON, ALEXIS P (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:P
Last Name:BARON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3935
Mailing Address - Country:US
Mailing Address - Phone:602-369-5397
Mailing Address - Fax:
Practice Address - Street 1:4413 N 35TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3935
Practice Address - Country:US
Practice Address - Phone:602-369-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-210991041C0700X
AZLCSW-161941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical