Provider Demographics
NPI:1295707495
Name:ENIX, LENORA JUANITA (PSYD)
Entity type:Individual
Prefix:DR
First Name:LENORA
Middle Name:JUANITA
Last Name:ENIX
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BEAUMONT AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4285
Mailing Address - Country:US
Mailing Address - Phone:205-356-7836
Mailing Address - Fax:205-208-0147
Practice Address - Street 1:725 N 12TH AVE BLDG B
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-8752
Practice Address - Country:US
Practice Address - Phone:863-494-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL923103T00000X
FLPY11894103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL890012030Medicaid
ALP27038Medicare UPIN
AL890012030Medicaid