Provider Demographics
NPI:1669897682
Name:BARTHOLOMEW, ALEXIS R (LMFT)
Entity type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:R
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HIGHWAY 7
Mailing Address - Street 2:SUITE 309
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55305
Mailing Address - Country:US
Mailing Address - Phone:952-426-6600
Mailing Address - Fax:952-938-4708
Practice Address - Street 1:621 W LAKE ST STE 350
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2952
Practice Address - Country:US
Practice Address - Phone:612-979-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3166106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist