Provider Demographics
NPI:1043041122
Name:WINSOR, ALEXIS B
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:B
Last Name:WINSOR
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 1:2107 CASPIAN CT
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36804-9605
Mailing Address - Country:US
Mailing Address - Phone:334-614-2692
Mailing Address - Fax:
Practice Address - Street 1:166 N GAY ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4800
Practice Address - Country:US
Practice Address - Phone:334-329-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty