Provider Demographics
NPI:1740900182
Name:BERGEY, ALEXIS (LPC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:BERGEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-3939
Mailing Address - Country:US
Mailing Address - Phone:405-714-0798
Mailing Address - Fax:
Practice Address - Street 1:2542 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-3939
Practice Address - Country:US
Practice Address - Phone:405-714-0798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor