Provider Demographics
NPI:1326330234
Name:IMMANUEL COUNSELING MINISTRIES, INC.
Entity Type:Organization
Organization Name:IMMANUEL COUNSELING MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RHODES
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, MS
Authorized Official - Phone:205-877-9767
Mailing Address - Street 1:1 METROPLEX DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6893
Mailing Address - Country:US
Mailing Address - Phone:205-877-9767
Mailing Address - Fax:205-877-9768
Practice Address - Street 1:1 METROPLEX DR
Practice Address - Street 2:SUITE 150
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6893
Practice Address - Country:US
Practice Address - Phone:205-877-9767
Practice Address - Fax:205-877-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty