Provider Demographics
NPI:1932864931
Name:WOODS, ALYSE D (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:ALYSE
Middle Name:D
Last Name:WOODS
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4737 KITTY DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-5917
Mailing Address - Country:US
Mailing Address - Phone:615-614-8636
Mailing Address - Fax:
Practice Address - Street 1:133 INDIAN LAKE RD STE 204
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3883
Practice Address - Country:US
Practice Address - Phone:615-338-6341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional