1902461031 NPI number — ALEXIS SAVILLE LICSW

Table of content: ALEXIS SAVILLE LICSW (NPI 1902461031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902461031 NPI number — ALEXIS SAVILLE LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAVILLE
Provider First Name:
ALEXIS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARCUS
Provider Other First Name:
ALEXIS
Provider Other Middle Name:
KELLY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902461031
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 LAKESHORE DR STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35209-8832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-871-6926
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2204 LAKESHORE DR STE 440
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMEWOOD
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35209-8857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-807-1740
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2019

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: 1041C0700X , with the licence number:  4434C , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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