Individual provider Active NPI

Alexis Powers, LCPC

  • Mental Health Counselor
  • Columbia, MD
National Provider Identifier
1104482561
Registry record updated Sep 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC13752 Issued in MD
Practice address
11006A Wood Elves Way
Columbia, MD 21044-1004
Phone
(410) 375-0002
Fax
(443) 524-9395
NPI assigned
May 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LGP6698 MD
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X LC13752 MD Primary

Addresses

Primary practice location

11006A Wood Elves Way
Columbia, MD 21044-1004

Mailing address

11006A Wood Elves Way
Columbia, MD 21044-1004
Phone (410) 375-0002

Other identifiers 4

IdentifierTypeStateIssuer
LGP6698MedicaidMD
LGP6698OtherMDAETNA
LGP6698OtherMDUNITED
LGP6698OtherMDCAREFIRST BLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240923000062 DC Practitioner - Mental Health Counselor 0941741656 Reassigns benefits to 1 organization
I20251124001761 CA Practitioner - Mental Health Counselor 0941741656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP6698MDMDProfessional Counselor
21041CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 9, 2024 Accepting new patients
Grow Healthcare Group PC Mental Health CurrentSince Oct 14, 2025 Accepting new patients
A Powerful Life LLC Mental Health CurrentSince Nov 5, 2023 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694217600000",
    "number": "1104482561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11006A WOOD ELVES WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210441004",
            "telephone_number": "410-375-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11006A WOOD ELVES WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210441004",
            "telephone_number": "410-375-0002",
            "fax_number": "443-524-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "ALEXIS",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-11",
        "last_updated": "2023-09-09",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP6698",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC13752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LGP6698",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "LGP6698",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "LGP6698",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECROSS BLUESHIELD",
            "identifier": "LGP6698",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.