Provider Demographics
NPI:1457000614
Name:WORKMAN, ALEXIS N (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:N
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MARSH LNDG S
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439-3955
Mailing Address - Country:US
Mailing Address - Phone:850-419-6831
Mailing Address - Fax:
Practice Address - Street 1:225 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2550
Practice Address - Country:US
Practice Address - Phone:850-781-0406
Practice Address - Fax:850-378-5233
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FL1-24-71537103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician