Healthcare Provider Details

I. General information

NPI: 1457000614
Provider Name (Legal Business Name): ALEXIS WORKMAN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGTREE DR STE 100
COLUMBIA SC
29223-8614
US

IV. Provider business mailing address

200 SPRINGTREE DR STE 100
COLUMBIA SC
29223-8614
US

V. Phone/Fax

Practice location:
  • Phone: 803-335-0718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-71537
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: