Healthcare Provider Details
I. General information
NPI: 1477719011
Provider Name (Legal Business Name): ALEXIS R BROWN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/04/2008
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15864 LAUREL OAK CIR
DELRAY BEACH FL
33484-5535
US
IV. Provider business mailing address
15864 LAUREL OAK CIR
DELRAY BEACH FL
33484-5535
US
V. Phone/Fax
- Phone: 561-577-8194
- Fax:
- Phone: 561-577-8194
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | PS002007L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | PA002007L |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | PS002007L |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PA002007L |
| License Number State | PA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0700X |
| Taxonomy | Adult Development & Aging Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0200X |
| Taxonomy | Forensic Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | PS002007L |
| License Number State | PA |
| # 15 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | PA002007L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
