Active NPI
Alexandria Kristen Roy, LCSW
- Clinical Social Worker
- Wilmington, NC
National Provider Identifier
1124526546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C013021
- Practice address
- 330 Shipyard Blvd
Wilmington, NC 28412-1837 - Phone
- (910) 343-0145
- NPI assigned
- Jan 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C013021 | NC | Primary |
Addresses
Primary practice location
330 Shipyard Blvd
Wilmington, NC 28412-1837
Mailing address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 202-5709
Other practice location 1
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 899-7099
Other practice location 2
309 Progress Dr
Burgaw, NC 28425-3280
Phone (910) 259-0668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 17, 2024 through Jan 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C013021 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Horizons Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Wilmington, NC
- NPI 1831333467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1124526546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-202-5709",
"fax_number": "910-202-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284121837",
"telephone_number": "910-343-0145"
}
],
"practiceLocations": [
{
"address_1": "615 Shipyard Blvd",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284126431",
"country_code": "US",
"telephone_number": "910-899-7099",
"fax_number": "910-202-9966",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "309 Progress Dr",
"address_purpose": "LOCATION",
"city": "Burgaw",
"state": "NC",
"postal_code": "284253280",
"country_code": "US",
"telephone_number": "910-259-0668",
"fax_number": "910-202-9966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROY",
"first_name": "ALEXANDRIA",
"middle_name": "KRISTEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-31",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C013021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.