Healthcare Provider Details

I. General information

NPI: 1528769759
Provider Name (Legal Business Name): AFAG ALIZADA LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AFA ALIZADA LCPC

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST STE 200
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST STE 200
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 301-200-2188
  • Fax:
Mailing address:
  • Phone: 301-200-2188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC16748
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: