Provider Demographics
NPI:1760197354
Name:ALEXANDER, FAITH (NCPSS)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:NCPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MAPLE AVE UNIT 245
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-0839
Mailing Address - Country:US
Mailing Address - Phone:336-539-6893
Mailing Address - Fax:
Practice Address - Street 1:322 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217
Practice Address - Country:US
Practice Address - Phone:336-539-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP1600X, 171400000X, 172V00000X, 174200000X
NC2024-9542-01175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
No174200000XOther Service ProvidersMeals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC000000Medicaid