Alexis Callahan

Individual provider Active NPI Mental Health Counselor · Pawtucket, RI

NPI 1043906407 · NPPES record last updated Nov 21, 2025

Key facts

NPI
1043906407
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MHC00450-A (RI)
Practice address
105 Bacon St
Pawtucket, RI 02860-5542
Phone
(401) 722-3560
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MHC00450-ARIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Healthcare Inc Current
since Apr 23, 2023
Accepting new patients

Locations

105 Bacon St
Pawtucket, RI 02860
Phone (401) 722-3560

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHC00450-A RI Yes

Addresses

Primary practice location

105 Bacon St
Pawtucket, RI 02860-5542

Mailing address

700 Metacom Ave Apt 112
Warren, RI 02885-2334
Phone (443) 786-0305

Other providers in Pawtucket, RI

All providers in Pawtucket, RI · Mental Health Counselor in Rhode Island

Sources for this page

Verify at the official NPI Registry.