Provider Demographics
NPI:1891476040
Name:PIVOT COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PIVOT COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TRENT
Authorized Official - Last Name:BAMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:205-316-8538
Mailing Address - Street 1:107 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35042-2423
Mailing Address - Country:US
Mailing Address - Phone:205-316-8538
Mailing Address - Fax:
Practice Address - Street 1:116 COURT SQUARE EAST
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:AL
Practice Address - Zip Code:35042-3504
Practice Address - Country:US
Practice Address - Phone:205-316-8538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty