MEDICARE: ALEXIS ANN LANDRAM LPC

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
1	101YM0800X	Mental Health Counselor	PC011233	PA

General Provider Information

NPI Number	:	1700440385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS ANN LANDRAM LPC

Provider Business Mailing Address
First Line	:	911 FAWCETT AVE
Second Line	:
City	:	MCKEESPORT
State	:	PA
Zip	:	15132-1409
Country	:	US
Telephone Number	:	412-609-4346
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 TOWN CENTER BLVD
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-5841
Country	:	US
Telephone Number	:	412-848-9905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2019
Last Update Date	:	06/14/2026

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Directions to “ ALEXIS ANN LANDRAM LPC” Practice Location

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