Provider Demographics
NPI:1629632179
Name:PRINCE, JAMES TALBERT JR (LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:TALBERT
Last Name:PRINCE
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CAHABA PARK CIR STE 104
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-8117
Mailing Address - Country:US
Mailing Address - Phone:205-903-6282
Mailing Address - Fax:
Practice Address - Street 1:200 CAHABA PARK CIR STE 104
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-8117
Practice Address - Country:US
Practice Address - Phone:205-903-6282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty