Healthcare Provider Details

I. General information

NPI: 1407718604
Provider Name (Legal Business Name): ALEXIS BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 22ND AVE NW STE U2
MINOT ND
58703-0986
US

IV. Provider business mailing address

600 22ND AVE NW STE U2
MINOT ND
58703-0986
US

V. Phone/Fax

Practice location:
  • Phone: 701-712-1292
  • Fax: 701-299-5883
Mailing address:
  • Phone: 701-712-1292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16321
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-0486
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC25561
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2607664
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32355
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1130577
License Number StateMA
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18507
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: