DR. ALEXANDRA BROUSTOVETSKAIA (NPI# 1124516026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124516026 |
| Entity Type | Individual |
| Full Name | DR. ALEXANDRA BROUSTOVETSKAIA |
| Credential | PH.D. |
| Practice Address |
8303 Six Forks Rd Ste 207 Raleigh NC 27615 |
| Mailing Address |
8303 Six Forks Rd Ste 207 Raleigh NC 27615-3094 |
| Practice Telephone | 9192457791 |
| Mailing Telephone | 9192457791 |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
10641 | MA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 400 Fenway, Boston, MA 021155725 | 6177359920 |
| Street Address |
8303 SIX FORKS RD STE 207 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669610333 | Lisa J. Ficker | Psychologist | 8303 Six Forks Rd Ste 207, Raleigh, NC 27615-3094 | 2009-02-03 |
| 1871076406 | Breyta Psychological Services, P.a. | Psychologist | 8303 Six Forks Rd Ste 207, Raleigh, NC 27615-3094 | 2018-09-10 |
| 1780029488 | Vanessa Handsel Roddenberry | Psychologist | 8303 Six Forks Rd Ste 207, Raleigh, NC 27615-3094 | 2013-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278535 | Emily Grace Johnson | Behavior Technician | 119 Wind Chime Court, Suite 4, Raleigh, NC 27615 | 2020-09-06 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1023503950 | Siyara Shannay Dobbs | Social Worker | 7013 Woodbend Dr Apt H, Raleigh, NC 27615 | 2018-06-23 |
| 1194210153 | Brittanie Ja'nell Harris | Dentist | 1911 Falls Valley Dr Ste 107, Raleigh, NC 27615 | 2018-06-22 |
| 1710489448 | Sherise Swensen | Social Worker | 8368 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2018-03-08 |
| 1881100345 | Casey Paul Baine | Counselor | 6330 Falls of Neuse Rd Ste 104, Raleigh, NC 27615 | 2017-12-20 |
| 1588177885 | Michael Lacidonia | Acupuncturist | 6400 Falls of Neuse Rd Ste 200, Raleigh, NC 27615 | 2017-11-08 |
| 1457877631 | Matt Henderson | Behavioral Analyst | 8374 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2017-08-18 |
| 1760907646 | Shakeda Muldrow | Social Worker | 7323 Brookbank Lane, Raleigh, NC 27615 | 2017-08-11 |
| Find all providers in zip 27615 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710507314 | Allison Irving | Psychologist | 3119 Briar Stream Run, Raleigh, NC 27612-5241 | 2020-04-23 |
| 1811144942 | Rachael Hollister Wooten | Psychologist | 2721 Kittrell Dr., Raleigh, NC 27608 | 2008-08-20 |
| 1740441575 | William Clifton Branch Jr. | Psychologist | 6701 Ascot Ct, Raleigh, NC 27615-7325 | 2008-06-24 |
| 1609903236 | Alice Ann Moore | Psychologist | 8120 Pony Pasture Ct, Raleigh, NC 27612-7378 | 2007-02-28 |
| 1750434767 | Les Brinson | Psychologist | 4617 Limerick Dr, Raleigh, NC 27604-3525 | 2007-01-21 |
| 1508807033 | Stephen John Flannelly | Psychologist | 8524 Six Forks Rd, Suite 203, Raleigh, NC 27615-3099 | 2006-06-08 |
| 1487113353 | Clark Slagle | Psychologist | 901 Paverstone Dr, Raleigh, NC 27615-4710 | 2019-03-19 |
| 1750874855 | Anna Katherine Smith | Psychologist | 9205 Baileywick Rd Ste 200, Raleigh, NC 27615-1977 | 2018-06-13 |
| 1396058400 | Rachel Lynn Ford | Psychologist | 610 W Peace St, Raleigh, NC 27605-1520 | 2010-07-17 |
| 1770895310 | Lutheran Family Services In The Carolinas | Psychologist | 616 Hutton St, Raleigh, NC 27606-1444 | 2010-07-12 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.