Healthcare Provider Details

I. General information

NPI: 1740798636
Provider Name (Legal Business Name): ALPHA COUNSELING AND TREATMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2018
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WALTER WARD BLVD STE 200
ABINGDON MD
21009-1285
US

IV. Provider business mailing address

100 WALTER WARD BLVD STE 200
ABINGDON MD
21009-1285
US

V. Phone/Fax

Practice location:
  • Phone: 410-777-8971
  • Fax: 877-895-7180
Mailing address:
  • Phone: 410-777-8971
  • Fax: 877-895-7180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: RITU T BHAMBHANI
Title or Position: MANAGER
Credential: MD
Phone: 410-777-8971