Provider Demographics
NPI:1134959752
Name:JUDEIKIS, ALEXIS
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:JUDEIKIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 COUNTY ROUTE 359
Mailing Address - Street 2:
Mailing Address - City:RENSSELAERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12147-2209
Mailing Address - Country:US
Mailing Address - Phone:518-819-9448
Mailing Address - Fax:
Practice Address - Street 1:232 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-4020
Practice Address - Country:US
Practice Address - Phone:845-304-5082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health