Alexis Elizabeth Wolf, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-16511 Issued in AZ

Practice address

1979 McCulloch Blvd N Ste 202
Lake Havasu City, AZ 86403-0968

Phone

(928) 920-6873

NPI assigned

Oct 15, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1861903098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1979 MCCULLOCH BLVD N STE 202",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864030968",
            "telephone_number": "928-920-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 MCCULLOCH BLVD N STE 202",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864030968",
            "telephone_number": "928-920-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "ALEXIS",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-15",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-16511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Susan Williams, MS LPC
• Lisa Victoria Williams, PA
• Brandy Lee Wilson, LPN
• Tin T Win, M.D.
• Adejare Windokun, MD
• Woman and Child Health, PC
• Womens Medical Health Center Inc
• Francis Jonathan Woo, MD
• Stephanie Woo, OD
• Brittany Woodall, DO

• Mental Health Counselor in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.