Provider Demographics
NPI:1851779284
Name:MCCOMMON, JAMES RICHARD (MS, ALC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:MCCOMMON
Suffix:
Gender:M
Credentials:MS, ALC
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:MCCOMMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1300 MONTEZUMA AVE
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-3202
Mailing Address - Country:US
Mailing Address - Phone:334-790-3726
Mailing Address - Fax:
Practice Address - Street 1:1300 MONTEZUMA AVE
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-3202
Practice Address - Country:US
Practice Address - Phone:334-790-3726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC # C2464A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor