Provider Demographics
NPI:1235747932
Name:TUSCALOOSA CENTER FOR COGNITIVE THERAPY, LLC
Entity Type:Organization
Organization Name:TUSCALOOSA CENTER FOR COGNITIVE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:CHAMBERS
Authorized Official - Last Name:VAUGHANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, NCC, BSN
Authorized Official - Phone:205-759-8470
Mailing Address - Street 1:2720 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1731
Mailing Address - Country:US
Mailing Address - Phone:205-759-8470
Mailing Address - Fax:205-366-9001
Practice Address - Street 1:2720 6TH ST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1731
Practice Address - Country:US
Practice Address - Phone:205-759-8470
Practice Address - Fax:205-366-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health