Provider Demographics
NPI:1508391632
Name:WITHOUT WALLS COUNSELING, PC
Entity Type:Organization
Organization Name:WITHOUT WALLS COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ AUTHORIZED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:THANDI
Authorized Official - Middle Name:KENYETTA
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LPC
Authorized Official - Phone:205-919-3974
Mailing Address - Street 1:2100 SOUTHBRIDGE PKWY STE 650
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1302
Mailing Address - Country:US
Mailing Address - Phone:205-414-7426
Mailing Address - Fax:877-308-8259
Practice Address - Street 1:2100 SOUTHBRIDGE PKWY STE 650
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1302
Practice Address - Country:US
Practice Address - Phone:205-414-7426
Practice Address - Fax:877-308-8259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL13980211OtherCAQH