Provider Demographics
NPI:1558856732
Name:BIRMINGHAM ACTION CENTERED THERAPY
Entity Type:Organization
Organization Name:BIRMINGHAM ACTION CENTERED THERAPY
Other - Org Name:BACT
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:CAINES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, PIP, TEP, MAC
Authorized Official - Phone:205-249-7048
Mailing Address - Street 1:2109 DARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3007
Mailing Address - Country:US
Mailing Address - Phone:205-820-7374
Mailing Address - Fax:205-978-0072
Practice Address - Street 1:2109 DARLINGTON ST
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3007
Practice Address - Country:US
Practice Address - Phone:205-820-7374
Practice Address - Fax:205-978-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1643C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty