Provider Demographics
NPI:1629794953
Name:KESSLER COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:KESSLER COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:III
Authorized Official - Credentials:ALC, NCC
Authorized Official - Phone:205-807-9334
Mailing Address - Street 1:1701 1ST AVE S APT 537
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1855
Mailing Address - Country:US
Mailing Address - Phone:205-807-9334
Mailing Address - Fax:
Practice Address - Street 1:1025 MONTGOMERY HWY STE 217
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-2830
Practice Address - Country:US
Practice Address - Phone:205-807-9334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3000016683Medicaid