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General NPI Number Information
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NPI Number | 1174243679
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Entity Type | Organization
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Legal Business Name | ALPHA COUNSELING SERVICES PLLC.
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 15050 EDERBERRY LANE SUITE 6
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City | FORT MYERS
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State | FL
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Zip | 33907
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Country | US
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Telephone | 239-214-3822
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Fax | 239-214-3822
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Provider Business Mailing Address
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Address Line | 15050 EDERBERRY LANE SUITE 6 15050 ELDERBERRY LANE SUITE 6
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City | FORT MYERS
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State | FL
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Zip | 33907
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Country | US
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Telephone | 239-214-3822
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Fax | 239-766-7533
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Authorized Official
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Title or Position | CEO/ PROVIDER
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Name | JOHNNIE TERRELL
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Credential |
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Telephone | 239-214-3822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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