Provider Demographics
NPI:1003583584
Name:BIRDSONG, DANIEL JACKSON (LPC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JACKSON
Last Name:BIRDSONG
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:MONTEVALLO
Mailing Address - State:AL
Mailing Address - Zip Code:35115-3730
Mailing Address - Country:US
Mailing Address - Phone:205-907-6626
Mailing Address - Fax:
Practice Address - Street 1:731 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:MONTEVALLO
Practice Address - State:AL
Practice Address - Zip Code:35115-3730
Practice Address - Country:US
Practice Address - Phone:205-382-8550
Practice Address - Fax:205-382-8550
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional