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NPI Code Detail

MEDICARE: ALEXIS ACEVEDO LMHC-D, LPC, CASAC-M

MEDICARE: ALEXIS ACEVEDO LMHC-D, LPC, CASAC-M
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor008501NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1133306195OTHERACT
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073904975
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS ACEVEDO LMHC-D, LPC, CASAC-M
Provider Business Mailing Address
First Line : 159 20TH ST STE 1B
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-1254
Country : US
Telephone Number : 646-685-4422
Fax Number : 516-218-7964
Provider Business Practice Location Address
First Line : 159 20TH ST STE 1B
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-1254
Country : US
Telephone Number : 646-685-4422
Fax Number : 516-218-7964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2015
Last Update Date : 06/13/2025

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