Individual provider Active NPI

Alexis Dunlap, IMFT

  • Marriage & Family Therapist
  • Van Wert, OH
National Provider Identifier
1194214817
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
F.2000148 Issued in OH
Practice address
533 S Harrison St
Van Wert, OH 45891-2022
Phone
(419) 605-8229
NPI assigned
May 8, 2018
Last updated
Oct 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X M.1700050 OH
Marriage & Family Therapist 106H00000X F.2000148 OH Primary

Addresses

Primary practice location

533 S Harrison St
Van Wert, OH 45891-2022

Mailing address

533 S Harrison St
Van Wert, OH 45891-2022
Phone (419) 605-8229

Other practice location 1

4938 State Route 111
Antwerp, OH 45813-9724
Phone (419) 285-6461

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

State licenses

LicenseStateTypeSpecialty
F.2000148OHMDMarriage & Family Therapist
M.1700050OHMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Woman Counseling and Wellness CurrentSince Nov 6, 2022 Accepting new patients
Restored Roots Counseling & Wellness Marriage & Family Therapist CurrentSince Jan 3, 2021 Accepting new patients
Village Network Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1194214817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 S HARRISON ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912022",
            "telephone_number": "419-605-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 S HARRISON ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912022",
            "telephone_number": "419-605-8229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4938 State Route 111",
            "address_purpose": "LOCATION",
            "city": "Antwerp",
            "state": "OH",
            "postal_code": "458139724",
            "country_code": "US",
            "telephone_number": "419-285-6461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNLAP",
        "first_name": "ALEXIS",
        "credential": "IMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M.1700050",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "F.2000148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.