Provider Demographics
NPI:1851301337
Name:PHILLIPS, DONALD L (MS, LPC, NCC, MAC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MS, LPC, NCC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 GOVERNOR'S DRIVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-2710
Mailing Address - Country:US
Mailing Address - Phone:256-489-2380
Mailing Address - Fax:256-489-2381
Practice Address - Street 1:250 GOVERNOR'S DRIVE
Practice Address - Street 2:SUITE J
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-2710
Practice Address - Country:US
Practice Address - Phone:256-489-2380
Practice Address - Fax:256-489-2381
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2517101Y00000X
101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51121040OtherBLUE CROSS
AL51593458OtherBCBS
AL51528995OtherBCBS
AL51591943OtherBCBS