Healthcare Provider Details

I. General information

NPI: 1194649640
Provider Name (Legal Business Name): BRANDON ALEXANDER MS, NCPT, CKM, QMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WARWICK BLVD
NEWPORT NEWS VA
23607-1514
US

IV. Provider business mailing address

7320 WARWICK BLVD
NEWPORT NEWS VA
23607-1514
US

V. Phone/Fax

Practice location:
  • Phone: 301-741-9618
  • Fax:
Mailing address:
  • Phone: 301-741-9618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0734014849
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number0734014849
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0245024790
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number0734014849
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: