Provider Demographics
NPI:1396893020
Name:ALPHA HOPE COUNSELING, INC
Entity type:Organization
Organization Name:ALPHA HOPE COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS,LPC,NCC,CPCS
Authorized Official - Phone:706-216-4735
Mailing Address - Street 1:137 PROMINENCE CT STE 220
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-8939
Mailing Address - Country:US
Mailing Address - Phone:706-216-4735
Mailing Address - Fax:706-216-7909
Practice Address - Street 1:137 PROMINENCE CT STE 220
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-8939
Practice Address - Country:US
Practice Address - Phone:706-216-4735
Practice Address - Fax:706-216-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004310101YP2500X
GALPC002826101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA406922506AMedicaid
GA539682443AMedicaid