Healthcare Provider Details

I. General information

NPI: 1619613536
Provider Name (Legal Business Name): ALBERTA PROFESSIONAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CENTERVIEW DR STE 300
GREENSBORO NC
27407-3708
US

IV. Provider business mailing address

PO BOX 14884
GREENSBORO NC
27415-4884
US

V. Phone/Fax

Practice location:
  • Phone: 336-273-2640
  • Fax: 336-273-6522
Mailing address:
  • Phone: 336-273-2640
  • Fax: 336-273-6522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER MAE GADD
Title or Position: CHIEF SERVICES OFFICER
Credential: LCSW
Phone: 336-967-2916