Provider Demographics
NPI:1780380022
Name:MCDANIELS-BROOKS, ALEXIS
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:MCDANIELS-BROOKS
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 1:620 CHURCHMANS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1945
Mailing Address - Country:US
Mailing Address - Phone:877-286-5115
Mailing Address - Fax:
Practice Address - Street 1:620 CHURCHMANS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1945
Practice Address - Country:US
Practice Address - Phone:877-286-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical