MEDICARE: ALEXIS JACQUEL LAW LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC05636	AL

General Provider Information

NPI Number	:	1659241529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS JACQUEL LAW LPC

Provider Business Mailing Address
First Line	:	1026 HIGHGROVE HTS NW
Second Line	:
City	:	HARVEST
State	:	AL
Zip	:	35749-5504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6767 OLD MADISON PIKE NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-2172
Country	:	US
Telephone Number	:	256-895-3848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	11/06/2025

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