Organization
ALEXANDER YOUTH NETWORK
Active
Other names
CABHA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENNON D GRAHAM (CEO)
(704) 366-8712
Entity
Organization
Contact information
Practice address
7670 NORTHPOINT CT., WISNTON-SALEM, NC 27106-3336
(336) 724-1412
(336) 724-1464
Mailing address
6220 THERMAL RD, CHARLOTTE, NC 28211-5630
(704) 366-8712
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410012
—
NC
05
—
6005550
—
NC
05
—
8300679
—
NC
05
—
8703028
—
NC
Enumeration date
08/17/2006
Last updated
08/28/2025
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