Basic Information
Provider Information
NPI: 1851793855
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALEXIS
FirstName: MARLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2187
Address2:  
City: SYLVA
State: NC
PostalCode: 287792187
CountryCode: US
TelephoneNumber: 8286313973
FaxNumber: 8286319280
Practice Location
Address1: 101 MANNING DR
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275144220
CountryCode: US
TelephoneNumber: 9849741000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/22/2014
LastUpdateDate: 08/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XC010434NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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