Provider Demographics
NPI:1235328576
Name:ALPHA ASSESSMENT & COUNSELING
Entity Type:Organization
Organization Name:ALPHA ASSESSMENT & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAYE
Authorized Official - Middle Name:LANGELY
Authorized Official - Last Name:AMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, MCP, LPC CANDA
Authorized Official - Phone:580-234-8865
Mailing Address - Street 1:114 E BROADWAY AVE
Mailing Address - Street 2:SUITE 702
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-4127
Mailing Address - Country:US
Mailing Address - Phone:580-234-8865
Mailing Address - Fax:580-234-8361
Practice Address - Street 1:114 E BROADWAY AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4127
Practice Address - Country:US
Practice Address - Phone:580-234-8865
Practice Address - Fax:580-234-8361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization