Provider Demographics
NPI:1528544632
Name:HOPKINS, ALPHONSO OWENS JR
Entity Type:Individual
Prefix:MR
First Name:ALPHONSO
Middle Name:OWENS
Last Name:HOPKINS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 SEDALIA RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27249-8734
Mailing Address - Country:US
Mailing Address - Phone:336-558-1943
Mailing Address - Fax:
Practice Address - Street 1:646 SEDALIA RD
Practice Address - Street 2:
Practice Address - City:GIBSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27249-8734
Practice Address - Country:US
Practice Address - Phone:336-558-1943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22622101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty