Provider Demographics
NPI:1083597017
Name:LAHODA, ALEXIS
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:LAHODA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:DURRENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:148 WINTER DR
Mailing Address - Street 2:
Mailing Address - City:DOWELLTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37059-1940
Mailing Address - Country:US
Mailing Address - Phone:615-545-8229
Mailing Address - Fax:
Practice Address - Street 1:1445 E 10TH ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2017
Practice Address - Country:US
Practice Address - Phone:931-372-2567
Practice Address - Fax:931-372-2572
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1919103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst