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General NPI Number Information
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NPI Number | 1174983837
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Entity Type | Organization
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Legal Business Name | ALPHA COUNSELING, PC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 651 CORPORATE CIR SUITE 120
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City | GOLDEN
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State | CO
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Zip | 80401-5651
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Country | US
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Telephone | 303-478-0522
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Fax | 303-238-2808
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Provider Business Mailing Address
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Address Line | 651 CORPORATE CIRCLE SUITE 120
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City | GOLDEN
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State | CO
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Zip | 80401
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Country | US
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Telephone | 303-478-0522
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Fax | 303-238-2808
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | MR. LAWRENCE TED GOMEZ JR.
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Credential | MA,LPC
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Telephone | 303-478-0522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0012368
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License Number State | CO
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