Provider Demographics
NPI:1871758268
Name:ALEXANDER, VERNETTE COOKE (LPA)
Entity type:Individual
Prefix:MRS
First Name:VERNETTE
Middle Name:COOKE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:MRS
Other - First Name:VERNETTE
Other - Middle Name:LEOLA
Other - Last Name:GILBREATH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPA
Mailing Address - Street 1:711 EXECUTIVE PL STE 327
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5193
Mailing Address - Country:US
Mailing Address - Phone:919-802-2797
Mailing Address - Fax:
Practice Address - Street 1:711 EXECUTIVE PL STE 327
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5193
Practice Address - Country:US
Practice Address - Phone:919-802-2797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3293103T00000X, 103TC0700X, 103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent