Provider Demographics
NPI:1356152284
Name:REDMAN, ALEXIS (LCSWA, LCASA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:REDMAN
Suffix:
Gender:F
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 1/2 PRINCESS ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-3951
Mailing Address - Country:US
Mailing Address - Phone:910-202-4326
Mailing Address - Fax:
Practice Address - Street 1:202 1/2 PRINCESS ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3951
Practice Address - Country:US
Practice Address - Phone:910-202-4326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP019674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health