Provider Demographics
NPI:1255869871
Name:COUNSELING SPECIALISTS OF BIRMINGHAM
Entity Type:Organization
Organization Name:COUNSELING SPECIALISTS OF BIRMINGHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:HILL
Authorized Official - Last Name:KLYCE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:770-596-5756
Mailing Address - Street 1:3864 TIMBERLINE WAY
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2452
Mailing Address - Country:US
Mailing Address - Phone:770-596-5756
Mailing Address - Fax:
Practice Address - Street 1:1116 23RD ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2410
Practice Address - Country:US
Practice Address - Phone:770-596-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3959C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty