Provider Demographics
NPI:1659646057
Name:ALEXANDER, CARLA S (LCSW-P)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:S
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCSW-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 COLLEGE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-2700
Mailing Address - Country:US
Mailing Address - Phone:336-818-0733
Mailing Address - Fax:336-818-0733
Practice Address - Street 1:1260 COLLEGE AVE STE 1
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2700
Practice Address - Country:US
Practice Address - Phone:336-818-0733
Practice Address - Fax:336-818-0733
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0054371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical