Provider Demographics
NPI:1194085928
Name:ALDON
Entity type:Organization
Organization Name:ALDON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:BRAXTON
Authorized Official - Last Name:ARNASONBRAXTONA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:240-667-4290
Mailing Address - Street 1:8955 EDMONSTON RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1006
Mailing Address - Country:US
Mailing Address - Phone:240-667-4290
Mailing Address - Fax:240-539-0216
Practice Address - Street 1:7105 PONY TRAIL LN
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-1031
Practice Address - Country:US
Practice Address - Phone:240-667-4290
Practice Address - Fax:240-539-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-27
Last Update Date:2012-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDYA2928OtherANTHEM EAP