Healthcare Provider Details

I. General information

NPI: 1710760509
Provider Name (Legal Business Name): ALEXANDRA NEBEL CRC, LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 CLOISTER CT
CHAPEL HILL NC
27514-2276
US

IV. Provider business mailing address

102 WEATHERSTONE DR UNIT A
CHAPEL HILL NC
27514-1587
US

V. Phone/Fax

Practice location:
  • Phone: 407-797-3890
  • Fax:
Mailing address:
  • Phone: 407-797-3890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA19038
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number642059
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: