Provider Demographics
NPI:1205563087
Name:WESTMORELAND, ALEXIS (LAC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:TRAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2809 FOREST HOME RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5320
Mailing Address - Country:US
Mailing Address - Phone:866-972-1268
Mailing Address - Fax:
Practice Address - Street 1:112 N BETTIS ST
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-3301
Practice Address - Country:US
Practice Address - Phone:870-609-0034
Practice Address - Fax:870-609-0036
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health