Healthcare Provider Details

I. General information

NPI: 1629561543
Provider Name (Legal Business Name): ALEXIS SIPLE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 COLUMBIA AVE E STE 4
BATTLE CREEK MI
49014-5468
US

IV. Provider business mailing address

491 COLUMBIA AVE E STE 4
BATTLE CREEK MI
49014-5468
US

V. Phone/Fax

Practice location:
  • Phone: 269-962-9611
  • Fax: 269-962-9612
Mailing address:
  • Phone: 269-962-9611
  • Fax: 269-962-9612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019865
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: