Provider Demographics
NPI:1073922233
Name:FAMILY COUNSELING SERVICE OF TUSCALOOSA COUNTY, AL, INC.
Entity Type:Organization
Organization Name:FAMILY COUNSELING SERVICE OF TUSCALOOSA COUNTY, AL, INC.
Other - Org Name:FAMILY COUNSELING SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:205-752-2504
Mailing Address - Street 1:2020 PAUL W BRYANT DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2312
Mailing Address - Country:US
Mailing Address - Phone:205-752-2504
Mailing Address - Fax:205-345-4842
Practice Address - Street 1:2020 PAUL W BRYANT DR
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2312
Practice Address - Country:US
Practice Address - Phone:205-752-2504
Practice Address - Fax:205-345-4842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3036101YP2500X
AL3068101YP2500X
AL3618C1041C0700X
AL1133C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty