Provider Demographics
NPI:1831674076
Name:SCHUSTER-COUCH, ALICIA D
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:D
Last Name:SCHUSTER-COUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WHIRLAWAY DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-4289
Mailing Address - Country:US
Mailing Address - Phone:256-755-4599
Mailing Address - Fax:
Practice Address - Street 1:250 SUN TEMPLE DR STE C1
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-5925
Practice Address - Country:US
Practice Address - Phone:256-755-4599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3906101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional