Healthcare Provider Details

I. General information

NPI: 1598684912
Provider Name (Legal Business Name): ALISSA LEANN WOODWARD P-LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

100 STARR AVE STE K
STARKVILLE MS
39759-4032
US

IV. Provider business mailing address

1972 POOR HOUSE RD E
STARKVILLE MS
39759-5824
US

V. Phone/Fax

Practice location:
  • Phone: 662-667-8221
  • Fax:
Mailing address:
  • Phone: 662-295-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP-1486
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: