Provider Demographics
NPI:1386392389
Name:HOLLINGSWORTH, ALEXIS ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ELIZABETH
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:ELIZABETH
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10444 FOREST RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4211
Mailing Address - Country:US
Mailing Address - Phone:209-479-4151
Mailing Address - Fax:
Practice Address - Street 1:10444 FOREST RIDGE CT
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-4211
Practice Address - Country:US
Practice Address - Phone:209-479-4151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1322791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical