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General NPI Number Information
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NPI Number | 1699229104
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Entity Type | Individual
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Provider Name | ALEXIS M HARBISON LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 4100 W 3RD ST
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City | DAYTON
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State | OH
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Zip | 45428-9000
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Country | US
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Telephone | 937-268-6511
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26335
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City | TROTWOOD
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State | OH
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Zip | 45426-0335
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Country | US
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Telephone | 614-738-3821
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.1300653
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.1800984
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License Number State | OH
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