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NPI Code Detail

MEDICARE: DR. BERTHA B ALSTON

MEDICARE:  DR. BERTHA B ALSTON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1080DC
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1437680022
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BERTHA B ALSTON
Provider Business Mailing Address
First Line : 603 HALIFAX PL
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-2158
Country : US
Telephone Number : 301-437-1614
Fax Number :
Provider Business Practice Location Address
First Line : 603 HALIFAX PL
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-2158
Country : US
Telephone Number : 301-437-1614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2017
Last Update Date : 03/24/2017

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Directions to “ DR. BERTHA B ALSTON ” Practice Location

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