Provider Demographics
NPI:1255002242
Name:WEGERSKI, ALEXA (LCSWA)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:WEGERSKI
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 WESTON GREEN LOOP
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2272
Mailing Address - Country:US
Mailing Address - Phone:919-698-1579
Mailing Address - Fax:
Practice Address - Street 1:4805 GREEN RD STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2848
Practice Address - Country:US
Practice Address - Phone:919-872-6220
Practice Address - Fax:919-872-6223
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0169141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical