Healthcare Provider Details

I. General information

NPI: 1093610099
Provider Name (Legal Business Name): ALEXANDER MAGNUSON LCSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEX MAGNUSON LCSWA

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W WILLIAMS ST STE 200
APEX NC
27502-5205
US

IV. Provider business mailing address

800 W WILLIAMS ST STE 200
APEX NC
27502-5205
US

V. Phone/Fax

Practice location:
  • Phone: 919-335-5053
  • Fax:
Mailing address:
  • Phone: 919-335-5053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP024616
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: