Healthcare Provider Details

I. General information

NPI: 1013619196
Provider Name (Legal Business Name): ALEXIS LOUISE BREWER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 AFTON LN
SMITHFIELD NC
27577-4800
US

IV. Provider business mailing address

10 AFTON LN
SMITHFIELD NC
27577-4800
US

V. Phone/Fax

Practice location:
  • Phone: 919-307-6183
  • Fax:
Mailing address:
  • Phone: 919-396-2945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP018802
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: