Provider Demographics
NPI:1326511213
Name:EPIPHANY COUNSELING, LLC
Entity Type:Organization
Organization Name:EPIPHANY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-683-7333
Mailing Address - Street 1:209 WAINSCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35757-7663
Mailing Address - Country:US
Mailing Address - Phone:256-683-7333
Mailing Address - Fax:
Practice Address - Street 1:190 LIME QUARRY RD STE 212
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8976
Practice Address - Country:US
Practice Address - Phone:256-474-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EPIPHANY COUNSELING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)