Provider Demographics
NPI:1811433048
Name:ALAMO AREA COUNSELING AND BEHAVIORAL ASSOCIATES.PLLC
Entity type:Organization
Organization Name:ALAMO AREA COUNSELING AND BEHAVIORAL ASSOCIATES.PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BASHER
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LCDC
Authorized Official - Phone:210-646-4441
Mailing Address - Street 1:8211 CREEKRUN VW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3818
Mailing Address - Country:US
Mailing Address - Phone:210-573-6954
Mailing Address - Fax:
Practice Address - Street 1:8211 CREEKRUN VW
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3818
Practice Address - Country:US
Practice Address - Phone:210-573-6954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7782101YA0400X
TX61637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207223303Medicaid
11958203OtherCAQH
TX61637OtherLICENSED PROFESSIONAL COUSNELOR
TX7782OtherLICENSED CHEMICAL DEPENDENCY COUNSELOR