Provider Demographics
NPI:1649150137
Name:GLASGOW, ALEXIS STORM HEALY
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:STORM HEALY
Last Name:GLASGOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7972 NW 125TH TER
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4922
Mailing Address - Country:US
Mailing Address - Phone:954-881-5081
Mailing Address - Fax:
Practice Address - Street 1:819 NE 26TH ST
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1239
Practice Address - Country:US
Practice Address - Phone:954-390-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health