Healthcare Provider Details

I. General information

NPI: 1225748452
Provider Name (Legal Business Name): ALPHA COUNSELING AND TREATMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 CAMPBELL BLVD STE 112
WHITE MARSH MD
21162-5503
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:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier220141
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerMARYLAND DEPT OF HEALTH LAB PERMIT
# 2
Identifier21D2255255
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerCMS CLIA

VIII. Authorized Official

Name: RITU BHAMBHANI
Title or Position: OWNER
Credential: MD
Phone: 443-857-1416