Provider Demographics
NPI:1821654716
Name:ALLIANCE BEHAVIORAL COUNSELING
Entity Type:Organization
Organization Name:ALLIANCE BEHAVIORAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAUPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-303-6335
Mailing Address - Street 1:2021 CUNNINGHAM DR STE 316
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3369
Mailing Address - Country:US
Mailing Address - Phone:757-303-6335
Mailing Address - Fax:
Practice Address - Street 1:2021 CUNNINGHAM DR STE 316
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3369
Practice Address - Country:US
Practice Address - Phone:757-303-6335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health