Provider Demographics
NPI:1588060818
Name:ALFA COUNSELING & CONSULTATION, LLC
Entity type:Organization
Organization Name:ALFA COUNSELING & CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:614-545-8833
Mailing Address - Street 1:PO BOX 1213
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-6213
Mailing Address - Country:US
Mailing Address - Phone:614-547-9233
Mailing Address - Fax:
Practice Address - Street 1:200 W. BRIDGE STREET
Practice Address - Street 2:SUITE B
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2690
Practice Address - Country:US
Practice Address - Phone:614-547-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1000486101YP2500X
OHE.1000597261QM0855X
OHC.1000227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty