Provider Demographics
NPI:1134969769
Name:ALEXIS, BRANDY MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:MARIE
Last Name:ALEXIS
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 1:235 FOXBRIAR CT
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-3315
Mailing Address - Country:US
Mailing Address - Phone:213-454-8138
Mailing Address - Fax:
Practice Address - Street 1:235 FOXBRIAR CT
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-3315
Practice Address - Country:US
Practice Address - Phone:213-454-8138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA147671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical