Provider Demographics
NPI:1558874149
Name:ADVANCED BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:256-945-7959
Mailing Address - Street 1:300 CLINTON AVE W STE 21
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5590
Mailing Address - Country:US
Mailing Address - Phone:256-945-7959
Mailing Address - Fax:844-833-6066
Practice Address - Street 1:300 CLINTON AVE W STE 21
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5590
Practice Address - Country:US
Practice Address - Phone:256-945-7959
Practice Address - Fax:844-833-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2776261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health