Healthcare Provider Details

I. General information

NPI: 1174448864
Provider Name (Legal Business Name): ALEXIS LEE HALSTEAD PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 S EDGEWOOD ST
ARLINGTON VA
22204-4813
US

IV. Provider business mailing address

955 26TH ST NW APT 506
WASHINGTON DC
20037-2040
US

V. Phone/Fax

Practice location:
  • Phone: 703-214-7445
  • Fax: 571-982-3186
Mailing address:
  • Phone: 203-988-9577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217908
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: