Provider Demographics
NPI:1700319779
Name:ALKER, GARY (LCPC)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:ALKER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 VINEYARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5360
Mailing Address - Country:US
Mailing Address - Phone:410-744-1719
Mailing Address - Fax:
Practice Address - Street 1:800 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1722
Practice Address - Country:US
Practice Address - Phone:410-744-5937
Practice Address - Fax:410-744-4674
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional