Provider Demographics
NPI:1710293659
Name:ALPHA COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:ALPHA COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR AND PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:I
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:CADAC IV, ICAADC, LA
Authorized Official - Phone:317-899-2010
Mailing Address - Street 1:7330 DEERFIELD DR
Mailing Address - Street 2:GREENFIELD
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-9500
Mailing Address - Country:US
Mailing Address - Phone:317-899-2010
Mailing Address - Fax:317-898-0060
Practice Address - Street 1:9820 E 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-2303
Practice Address - Country:US
Practice Address - Phone:317-899-2010
Practice Address - Fax:317-898-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86000082A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty