Provider Demographics
NPI:1326928326
Name:PLATT, ALISA CATHERINE (ADT3590)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:CATHERINE
Last Name:PLATT
Suffix:
Gender:F
Credentials:ADT3590
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BLACKISTON AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3702
Mailing Address - Country:US
Mailing Address - Phone:301-687-0940
Mailing Address - Fax:301-687-0948
Practice Address - Street 1:14701 NATIONAL HWY SW
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-6573
Practice Address - Country:US
Practice Address - Phone:301-687-0940
Practice Address - Fax:301-687-0948
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3590101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)