Provider Demographics
NPI:1851840391
Name:PRUETT COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:PRUETT COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PRUETT
Authorized Official - Suffix:
Authorized Official - Credentials:MED, EDS, LPC
Authorized Official - Phone:205-912-2006
Mailing Address - Street 1:3 OFFICE PARK CIR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2510
Mailing Address - Country:US
Mailing Address - Phone:205-912-2006
Mailing Address - Fax:205-912-2006
Practice Address - Street 1:3 OFFICE PARK CIR
Practice Address - Street 2:SUITE 310
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2510
Practice Address - Country:US
Practice Address - Phone:205-912-2006
Practice Address - Fax:205-912-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2443101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty