Healthcare Provider Details

I. General information

NPI: 1639002496
Provider Name (Legal Business Name): ALAINA LEIGH MOCK ADT,CPRP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 CYNWOOD DR STE C
EASTON MD
21601-3886
US

IV. Provider business mailing address

312 LLOYDS CIR
HURLOCK MD
21643-3668
US

V. Phone/Fax

Practice location:
  • Phone: 410-725-3605
  • Fax:
Mailing address:
  • Phone: 410-725-3605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: