Provider Demographics
NPI:1609389824
Name:BEHAVIORAL & SUBSTANCE ABUSE COUNSELING LLC
Entity Type:Organization
Organization Name:BEHAVIORAL & SUBSTANCE ABUSE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:SALES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:615-777-9315
Mailing Address - Street 1:165 CHESTNUT DR STE C
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9525
Mailing Address - Country:US
Mailing Address - Phone:615-777-9303
Mailing Address - Fax:855-266-6947
Practice Address - Street 1:165 CHESTNUT DR STE C
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9525
Practice Address - Country:US
Practice Address - Phone:615-777-9303
Practice Address - Fax:855-266-6947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty