Provider Demographics
NPI:1972868594
Name:WEST MOBILE FAMILY COUNSELING
Entity Type:Organization
Organization Name:WEST MOBILE FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF PRIVATE PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:BURNS
Authorized Official - Last Name:BYRUM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:251-300-7861
Mailing Address - Street 1:2423 SCHILLINGER RD S STE 107
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-4142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2423 SCHILLINGER RD S STE 107
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4142
Practice Address - Country:US
Practice Address - Phone:251-639-2183
Practice Address - Fax:251-639-1796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL341106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty