Provider Demographics
NPI:1053969261
Name:ALLEN, ALISHA (LPC)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S RIPLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-3406
Mailing Address - Country:US
Mailing Address - Phone:989-465-7400
Mailing Address - Fax:989-465-7465
Practice Address - Street 1:PEACEFUL MIND THERAPEUTICS, PLLC
Practice Address - Street 2:150 S RIPLEY BLVD
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707
Practice Address - Country:US
Practice Address - Phone:989-465-7400
Practice Address - Fax:989-465-7465
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017602101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401223632OtherSTATE LICENSE