Provider Demographics
NPI:1972022721
Name:STRIVE COUNSELING SERVICES, L.L.C.
Entity Type:Organization
Organization Name:STRIVE COUNSELING SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MULLEN-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, PIP, RPT
Authorized Official - Phone:205-913-6078
Mailing Address - Street 1:601 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35206-1616
Mailing Address - Country:US
Mailing Address - Phone:205-913-6078
Mailing Address - Fax:
Practice Address - Street 1:2024 3RD AVE N STE 312
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-3302
Practice Address - Country:US
Practice Address - Phone:205-721-9893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1332-3980C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty