Provider Demographics
NPI:1295317998
Name:ALPHA COUNSELING GROUP LLC
Entity type:Organization
Organization Name:ALPHA COUNSELING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAHIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-674-1900
Mailing Address - Street 1:10135 GLENGATE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8607
Mailing Address - Country:US
Mailing Address - Phone:832-812-9829
Mailing Address - Fax:
Practice Address - Street 1:10135 GLENGATE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8607
Practice Address - Country:US
Practice Address - Phone:832-812-9829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty