Provider Demographics
NPI:1942631817
Name:SYNERGY MINISTRIES, INC.
Entity Type:Organization
Organization Name:SYNERGY MINISTRIES, INC.
Other - Org Name:SYNERGY COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:G
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, LPC
Authorized Official - Phone:256-979-1620
Mailing Address - Street 1:701B GAULT AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-2627
Mailing Address - Country:US
Mailing Address - Phone:256-979-1620
Mailing Address - Fax:205-263-6462
Practice Address - Street 1:701B GAULT AVE N
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-2627
Practice Address - Country:US
Practice Address - Phone:256-979-1620
Practice Address - Fax:205-263-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty