Provider Demographics
NPI:1174983837
Name:ALPHA COUNSELING, PC
Entity type:Organization
Organization Name:ALPHA COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:TED
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA,LPC
Authorized Official - Phone:303-478-0522
Mailing Address - Street 1:651 CORPORATE CIRCLE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401
Mailing Address - Country:US
Mailing Address - Phone:303-478-0522
Mailing Address - Fax:303-238-2808
Practice Address - Street 1:651 CORPORATE CIR
Practice Address - Street 2:SUITE 120
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5651
Practice Address - Country:US
Practice Address - Phone:303-478-0522
Practice Address - Fax:303-238-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012368251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health