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NPI Code Detail

MEDICARE: ALYSSA FENNER HARWOOD LPCC

MEDICARE: ALYSSA FENNER HARWOOD LPCC
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
1101Y00000XCounselorC1400294OH
2101YP2500XProfessional CounselorE.2001788OH

General Provider Information

NPI Number : 1336502194
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA FENNER HARWOOD LPCC
Provider Business Mailing Address
First Line : 178 PRIVATE DR. 19423
Second Line :
City : SOUTH POINT
State : OH
Zip : 45680-8831
Country : US
Telephone Number : 740-313-0040
Fax Number : 740-894-1132
Provider Business Practice Location Address
First Line : 178 PRIVATE DR. 19423
Second Line :
City : SOUTH POINT
State : OH
Zip : 45680-8831
Country : US
Telephone Number : 740-313-0040
Fax Number : 740-894-1132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2016
Last Update Date : 07/02/2020

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