Provider Demographics
NPI:1659022614
Name:ALPHA CONSULTING AND COUNSELING CENTER INC
Entity Type:Organization
Organization Name:ALPHA CONSULTING AND COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMISILE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-520-3620
Mailing Address - Street 1:101 BURRITT AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-5657
Mailing Address - Country:US
Mailing Address - Phone:203-520-3620
Mailing Address - Fax:
Practice Address - Street 1:61 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3285
Practice Address - Country:US
Practice Address - Phone:203-520-3620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)