Provider Demographics
NPI:1609508381
Name:MOUNT, ALEXIS (MCD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:MOUNT
Suffix:
Gender:
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BELVIEW RD
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-2904
Mailing Address - Country:US
Mailing Address - Phone:337-239-3401
Mailing Address - Fax:
Practice Address - Street 1:201 BELVIEW RD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-2904
Practice Address - Country:US
Practice Address - Phone:337-239-3401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA9082OtherTRICARE, BLUE CROSS BLUE SHIELD