Provider Demographics
NPI:1942953252
Name:FORTUNE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:FORTUNE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIVICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-492-4096
Mailing Address - Street 1:P O BOX 36702
Mailing Address - Street 2:1809 RIVERCHASE DRIVE
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35236
Mailing Address - Country:US
Mailing Address - Phone:205-471-7767
Mailing Address - Fax:
Practice Address - Street 1:7150 CAHABA VALLEY RD STE 201
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6697
Practice Address - Country:US
Practice Address - Phone:205-492-4096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty