Alexis Exum, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

07108 Issued in MD

Practice address

1110 Bonifant St Ste 201H
Silver Spring, MD 20910-3358

Phone

(804) 215-6247

NPI assigned

Apr 12, 2024

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

Specialties & licenses 13

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Clarity Rose Mental Health and Wellness Center, PLLC

  • Clinical Psychologist
  • Silver Spring, MD
  • NPI 1194531764
  NPD Authorized official

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1952155442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6249 GREENWICK DR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BONIFANT ST STE 201H",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103358",
            "telephone_number": "804-215-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXUM",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "07108",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810008497",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "VA",
            "license": "0810008497",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008497",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "VA",
            "license": "0810008497",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810008497",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "07108",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MD",
            "license": "07108",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MD",
            "license": "07108",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "VA",
            "license": "0810008497",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "VA",
            "license": "0810008497",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MD",
            "license": "07108",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "07108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.