Healthcare Provider Details

I. General information

NPI: 1609738616
Provider Name (Legal Business Name): ALPHA MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2025
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 THAYER CTR STE C
OAKLAND MD
21550-1139
US

IV. Provider business mailing address

12512 STURDEE DR
UPPER MARLBORO MD
20772-4222
US

V. Phone/Fax

Practice location:
  • Phone: 240-326-3570
  • Fax: 240-436-0575
Mailing address:
  • Phone: 240-838-8640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH OGUNSHOLA
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 202-702-4201