1114341641 NPI number — MS. ALEXIS HARRIS LPC

Table of content: MS. ALEXIS HARRIS LPC (NPI 1114341641)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114341641 NPI number — MS. ALEXIS HARRIS LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRIS
Provider First Name:
ALEXIS
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114341641
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
430 WARFIELD DR APT 2111
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANDOVER
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20785-4741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-326-3697
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3029 MARTIN LUTHER KING JR AVE SE FL 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20032-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-971-4051
Provider Business Practice Location Address Fax Number:
202-563-0109
Provider Enumeration Date:
02/04/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  PRC14220 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)