Provider Demographics
NPI:1265232706
Name:SABUL, ALEXIS MARIE KOERNER (LCSWA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MARIE KOERNER
Last Name:SABUL
Suffix:
Gender:
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-8767
Mailing Address - Country:US
Mailing Address - Phone:704-296-6186
Mailing Address - Fax:
Practice Address - Street 1:2330 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8767
Practice Address - Country:US
Practice Address - Phone:704-296-6186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0204751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical