SOUTHEAST ALABAMA YOUTH SERVICES NPI 1790575256

NPI Information

  • NPI: 1790575256
  • Provider Name: SOUTHEAST ALABAMA YOUTH SERVICES
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 2856 HORACE SHEPARD DR.
    DOTHAN, AL
    ZIP 36303
  • Phone: (334) 983-8377

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NPI Details

SOUTHEAST ALABAMA YOUTH SERVICES is a professional counselor in Dothan, AL. SOUTHEAST ALABAMA YOUTH SERVICES NPI is 1790575256. The provider is registered as an organization entity type.

The provider's business location address is:

2856 HORACE SHEPARD DR.
DOTHAN, AL
ZIP 36303
Phone: (334) 983-8377
Fax: (334) 983-1289

The provider's authorized official is Tabitha S Brannon .
The authorized official title is Executive Director and has the following contact phone number (334) 983-8377.

The enumeration date for this NPI number is 5/8/2025 and was last updated on 5/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2101YP2500XCounselorProfessionalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1339100015MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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