Provider Demographics
NPI:1083054399
Name:WITHOUT WALLS COUNSELING, PC
Entity Type:Organization
Organization Name:WITHOUT WALLS COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE SECRETARY/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:THANDI
Authorized Official - Middle Name:KENYETTA
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:205-919-3974
Mailing Address - Street 1:608 CHACE LAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3035
Mailing Address - Country:US
Mailing Address - Phone:205-919-3974
Mailing Address - Fax:
Practice Address - Street 1:2008 21ST STREET ENSLEY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35218-2963
Practice Address - Country:US
Practice Address - Phone:205-919-3974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health