Active NPI
Alexis Shay Dettwiler, M.A., APCC
- Professional Counselor
- Campbell, CA
National Provider Identifier
1184157604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 251 Llewellyn Ave
Campbell, CA 95008 - Phone
- (408) 335-3318
- NPI assigned
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
251 Llewellyn Ave
Campbell, CA 95008
Mailing address
251 Llewellyn Ave
Campbell, CA 95008-1940
Phone (408) 335-3318
Other practice location 1
1709 N Rocky Creek Ct
Wichita, KS 67230-1753
Phone (316) 253-3880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550016000000",
"number": "1184157604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 LLEWELLYN AVE",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950081940",
"telephone_number": "408-335-3318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 LLEWELLYN AVE",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "95008",
"telephone_number": "408-335-3318"
}
],
"practiceLocations": [
{
"address_1": "1709 N Rocky Creek Ct",
"address_purpose": "LOCATION",
"city": "Wichita",
"state": "KS",
"postal_code": "672301753",
"country_code": "US",
"telephone_number": "316-253-3880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DETTWILER",
"first_name": "ALEXIS",
"middle_name": "SHAY",
"credential": "M.A., APCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-11",
"last_updated": "2019-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.