NPI |
1811458946 |
The city name in the location address of the provider being identified. |
Entity Type Code |
2 |
The State code in the location of the provider
being identified. |
Employer Identification Number EIN |
|
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Organization Name Legal Business Name |
ALABAMA COUNSELING & CONSULTING SERVICES, LLC |
The country code in the location address of the provider being identified. |
Provider First Line Business Practice Location Address |
303 WILLIAMS AVE SW |
The telephone number associated with the location address of the provider being identified. |
Provider Second Line Business Practice Location Address |
STE 221 |
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot
include a Post Office box. |
Provider Business Practice Location Address City Name |
HUNTSVILLE |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
AL |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
358016001 |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
Provider Business Practice Location Address Telephone Number |
2565085803 |
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
Provider Enumeration Date |
3/29/2019 |
|
Last Update Date |
3/29/2019 |
|
Authorized Official Last Name |
ROBERTS |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
LAUREN |
The first name of the authorized official. |
Authorized Official Middle Name |
ADELE |
The middle name of the authorized official. |
Authorized Official Title or Position |
LICENSED PROFESSIONAL COUNSELOR |
The title or position of the authorized official. |
Authorized Official Telephone Number |
2568015157 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
101YM0800X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Organization Subpart |
N |
|
Authorized Official Credential Text |
MS, LPC |
|
Healthcare Provider Taxonomy Group 1 |
193400000X SINGLE SPECIALTY GROUP |
|