Provider Demographics
NPI:1265820831
Name:SHOALS COUNSELING, LLC
Entity Type:Organization
Organization Name:SHOALS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DENTON
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-740-1865
Mailing Address - Street 1:760 COUNTY ROAD 27
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35634-7800
Mailing Address - Country:US
Mailing Address - Phone:256-740-1865
Mailing Address - Fax:256-272-0363
Practice Address - Street 1:254 SEVILLE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1597
Practice Address - Country:US
Practice Address - Phone:256-740-1865
Practice Address - Fax:256-272-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty