MEDICARE: ALYSSA JAILEE ALBA LMHCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MHC00502-A	RI

General Provider Information

NPI Number	:	1023944626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA JAILEE ALBA LMHCA

Provider Business Mailing Address
First Line	:	33 COLLEGE HILL RD UNIT 31
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-2776
Country	:	US
Telephone Number	:	401-407-5665
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 COLLEGE HILL RD UNIT 31
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-2776
Country	:	US
Telephone Number	:	401-407-5665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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