Basic Information
| Provider Information | |||||||||
| NPI: | 1629300488 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALSTON | ||||||||
| FirstName: | ELMA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7225 BURNING TIMBER LN | ||||||||
| Address2: | |||||||||
| City: | OWINGS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207363036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2405065076 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1221 MERCANTILE LN | ||||||||
| Address2: | KAISER PERMANENTE LARGO MEDICAL CENTER | ||||||||
| City: | LARGO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207745374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016185500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2010 | ||||||||
| LastUpdateDate: | 05/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 09792 | MD | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.