Individual
ALEXIS Y MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 STEWART PKWY, WASHINGTON, NC 27889-4972
(252) 946-0585
Mailing address
2852 HOLLY GLEN DR APT C, GREENVILLE, NC 27834-8839
(910) 546-0891
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005782
—
NC
Enumeration date
12/30/2019
Last updated
01/23/2020
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