NPIMap

Organization Active NPI

Alexander Youth Network

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1609010842
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ALEXANDER YOUTH NETWORK
Practice address
5855 Executive Center Dr
Suite 105
Charlotte, NC 28212-8883
Phone
(704) 537-1202
Fax
(704) 537-1209
NPI assigned
Apr 30, 2009
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Mr. Brennon Graham
Title
Ceo
Phone
(704) 366-8712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

5855 Executive Center Dr
Suite 105
Charlotte, NC 28212-8883

Mailing address

PO Box 220632
Charlotte, NC 28222-0632
Phone (704) 366-8712

Other identifiers 5

IdentifierTypeStateIssuer
8300243BMedicaidNC
8300243GMedicaidNC
8300243IMedicaidNC
8300243MedicaidNC
8300243HMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Alexander Youth Network41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1609010842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220632",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282220632",
            "telephone_number": "704-366-8712",
            "fax_number": "704-362-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 EXECUTIVE CENTER DR",
            "address_2": "SUITE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128883",
            "telephone_number": "704-537-1202",
            "fax_number": "704-537-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDER YOUTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "BRENNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-366-8712",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300243B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300243G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300243I",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300243",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300243H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.