Alexcius Branch

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

3522 Habersham at Northlake Ste B
Tucker, GA 30084-4009

Phone

(901) 606-7966

NPI assigned

Mar 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Synergistix Universal LLC

  • Community Health Clinic/Center
  • Tucker, GA
  • NPI 1841876992

  Community Health Worker

  NPD Authorized official

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1972189017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 HABERSHAM AT NORTHLAKE STE B",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 HABERSHAM AT NORTHLAKE STE B",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844009",
            "telephone_number": "901-606-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "ALEXCIUS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH/MULTI-SERVICE",
            "identifier": "812990",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deirdre Bonaparte, MA, CCC-SLP
• Hannah Joy Boos, MA, LPC, NCC, CPTT
• William Alfred Bower, M.D.
• Malika A. Boyd, LCSW
• Sydney Janine Boyum, MASTER'S OF SCIENCE
• Joseph Olem Brannen, DDS
• Daniel Scott Braun, LCSW
• Tiffany Brennaman, LCSW
• Mary J Brennan, OT
• Briarwood Health Center by Harborview, LLC

• Pastoral Counselor in Tucker, GA
• Providers in Tucker, GA by specialty
• Pastoral Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.