Provider Demographics
NPI:1497121834
Name:CLECKNER, ALEXIS (LPC-A)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:CLECKNER
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7209 KENYON DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-1400
Mailing Address - Country:US
Mailing Address - Phone:704-565-9052
Mailing Address - Fax:
Practice Address - Street 1:7209 KENYON DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-1400
Practice Address - Country:US
Practice Address - Phone:704-565-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health