Provider Demographics
NPI:1184870800
Name:ALTERNATIVE LIFE SOLUTIONS COUNSELING PLLC
Entity type:Organization
Organization Name:ALTERNATIVE LIFE SOLUTIONS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S LSOTP
Authorized Official - Phone:432-582-2444
Mailing Address - Street 1:PO BOX 12462
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79768-2462
Mailing Address - Country:US
Mailing Address - Phone:432-582-2444
Mailing Address - Fax:432-582-2449
Practice Address - Street 1:2458 E 11TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4236
Practice Address - Country:US
Practice Address - Phone:432-582-2444
Practice Address - Fax:432-582-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20187101YP2500X
TX14764101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty