Provider Demographics
NPI:1366614224
Name:HORTON, ALEXIS (MA, LPC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W EXCHANGE ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2834
Mailing Address - Country:US
Mailing Address - Phone:989-723-8239
Mailing Address - Fax:989-723-8230
Practice Address - Street 1:120 W EXCHANGE ST
Practice Address - Street 2:STE. 300
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2834
Practice Address - Country:US
Practice Address - Phone:989-723-8239
Practice Address - Fax:989-723-8230
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010127101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)