Individual provider Active NPI

Alexa Danielle Delisle, PHD

  • Psychologist
  • Butner, NC
National Provider Identifier
1336867175
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6244 Issued in NC
Practice address
100 W H St
Butner, NC 27509-1605
Phone
(919) 338-8500
NPI assigned
Aug 18, 2022
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6244 NC Primary

Addresses

Primary practice location

100 W H St
Butner, NC 27509-1605

Mailing address

106 Chestnut St
Durham, NC 27707-1715
Phone (919) 452-0006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240802001695 NC Practitioner - Clinical Psychologist 1759828148 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6244NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Apr 3, 2024 Accepting new patients

Locations

100 W H St
Butner, NC 27509
Phone (919) 338-8500

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1336867175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CHESTNUT ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071715",
            "telephone_number": "919-452-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W H ST",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091605",
            "telephone_number": "919-338-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISLE",
        "first_name": "ALEXA",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "6244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butner, NC

Sources for this page

Verify at the official NPI Registry.