Provider Demographics
NPI:1275312134
Name:COMPLETE BEHAVIORAL HEALTH PLLC
Entity Type:Organization
Organization Name:COMPLETE BEHAVIORAL HEALTH PLLC
Other - Org Name:COMPLETE BEHAVIORAL HEALTH PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CICELY
Authorized Official - Middle Name:BAUGH
Authorized Official - Last Name:HOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-669-2205
Mailing Address - Street 1:4758 WOODMERE BLVD STE F5027
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3075
Mailing Address - Country:US
Mailing Address - Phone:888-970-9745
Mailing Address - Fax:
Practice Address - Street 1:4758 WOODMERE BLVD STE F5027
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3075
Practice Address - Country:US
Practice Address - Phone:334-669-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)