Provider Demographics
NPI:1013435452
Name:FUTCH, MAGGIE LEA (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:LEA
Last Name:FUTCH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 HOLMES AVE NE STE F
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4162
Mailing Address - Country:US
Mailing Address - Phone:256-203-6480
Mailing Address - Fax:256-350-3011
Practice Address - Street 1:401 HOLMES AVE NE STE F
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4162
Practice Address - Country:US
Practice Address - Phone:256-203-6480
Practice Address - Fax:256-350-3011
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3766101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional