Provider Demographics
NPI:1619279619
Name:WHEELER-SCRUGGS, KATHY (LPC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:WHEELER-SCRUGGS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-4378
Mailing Address - Country:US
Mailing Address - Phone:205-302-9066
Mailing Address - Fax:202-287-6972
Practice Address - Street 1:1105 7TH AVE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-4378
Practice Address - Country:US
Practice Address - Phone:205-302-9066
Practice Address - Fax:202-287-6972
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2872101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional