Provider Demographics
NPI:1689706301
Name:ALPHA COUNSELLORS
Entity Type:Organization
Organization Name:ALPHA COUNSELLORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBSTANCE ABUSE COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:CSAC
Authorized Official - Phone:757-344-0459
Mailing Address - Street 1:8 CATHY DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-1403
Mailing Address - Country:US
Mailing Address - Phone:757-344-0459
Mailing Address - Fax:
Practice Address - Street 1:2238 TODDS LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3159
Practice Address - Country:US
Practice Address - Phone:757-344-0459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710102044251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0710102044OtherBOARD OF COUNSELING LIC.