Healthcare Provider Details

I. General information

NPI: 1053193912
Provider Name (Legal Business Name): ALEXIS ELIZABETH RUIZ-HAMILTON LPC, ED.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXIS RUIZ ORTIZ LAC, ED.S

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 W WILBUR MILLS AVE
KENSETT AR
72082-9051
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006-0497
US

V. Phone/Fax

Practice location:
  • Phone: 501-742-5697
  • Fax: 501-742-3031
Mailing address:
  • Phone: 870-347-2534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2605010
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA2306025
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: