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General NPI Number Information
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NPI Number | 1174965891
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Entity Type | Organization
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Legal Business Name | ALPHA COUNSELING AND TREATMENT, INC
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 533 26TH ST
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City | OGDEN
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State | UT
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Zip | 84401-2465
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Country | US
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Telephone | 801-941-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 533 26TH ST
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City | OGDEN
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State | UT
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Zip | 84401-2465
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Country | US
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Telephone | 801-941-3334
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Fax |
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Authorized Official
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Title or Position | LEAD COUNSELOR
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Name | MR. JEFF SCOTT MOORE
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Credential | LCSW
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Telephone | 801-941-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 8425844-014
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 8425844-014
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8425844-014
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8425844-014
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License Number State | UT
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