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General NPI Number Information
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NPI Number | 1659264505
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Entity Type | Individual
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Provider Name | ALEXIS LIN FAHL
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 1621 MEDINA RD
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City | MEDINA
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State | OH
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Zip | 44256-5333
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Country | US
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Telephone | 216-320-6447
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Fax | 330-721-0013
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Provider Business Mailing Address
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Address Line | 1621 MEDINA RD
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City | MEDINA
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State | OH
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Zip | 44256-5333
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Country | US
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Telephone | 216-320-6447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2507665
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License Number State | OH
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