Provider Demographics
NPI:1861027005
Name:MASIKO-MEYER, ALEXANN CALABASH (LPCC, LPC, LCMHC)
Entity type:Individual
Prefix:
First Name:ALEXANN
Middle Name:CALABASH
Last Name:MASIKO-MEYER
Suffix:
Gender:F
Credentials:LPCC, LPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 DESCANSO ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-4804
Mailing Address - Country:US
Mailing Address - Phone:609-504-3468
Mailing Address - Fax:
Practice Address - Street 1:1011 PACIFIC ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-538-1836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11599101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional