Provider Demographics
NPI:1710856711
Name:WEBB, DESTINY ALEXIS MONAE
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:ALEXIS MONAE
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 LIMESTONE RD STE 200A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5536
Mailing Address - Country:US
Mailing Address - Phone:302-635-9111
Mailing Address - Fax:
Practice Address - Street 1:2055 LIMESTONE RD STE 200A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5536
Practice Address - Country:US
Practice Address - Phone:302-635-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAC-0010500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor