Provider Demographics
NPI:1891385993
Name:PROFESSIONAL COUNSELORS OF ALABAMA LLC
Entity Type:Organization
Organization Name:PROFESSIONAL COUNSELORS OF ALABAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHITCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:251-943-9440
Mailing Address - Street 1:8308 PALMETTO WAY
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-9058
Mailing Address - Country:US
Mailing Address - Phone:251-979-5538
Mailing Address - Fax:251-943-9444
Practice Address - Street 1:PROFESSIONAL COUNSELORS OF ALABAMA LLC
Practice Address - Street 2:316 S. MCKENZIE ST. SUITE 102
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3653
Practice Address - Country:US
Practice Address - Phone:251-943-9440
Practice Address - Fax:251-943-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty