Provider Demographics
NPI:1407587934
Name:EDWARDS, ALEXIS M (MS, RMHCI)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 MCKINLEY DR APT 11302
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-6457
Mailing Address - Country:US
Mailing Address - Phone:910-265-7735
Mailing Address - Fax:
Practice Address - Street 1:2203 N LOIS AVE STE 220
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-2370
Practice Address - Country:US
Practice Address - Phone:813-897-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor