Provider Demographics
NPI:1477997864
Name:STROUSE, ALEXIS SHEA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SHEA
Last Name:STROUSE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 PROVIDENCE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-5907
Mailing Address - Country:US
Mailing Address - Phone:734-780-1275
Mailing Address - Fax:
Practice Address - Street 1:5007 PROVIDENCE RD STE 105
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5907
Practice Address - Country:US
Practice Address - Phone:704-364-6594
Practice Address - Fax:704-362-4176
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0099471041C0700X
NCC1027541041C0700X
NCC0127541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical