Provider Demographics
NPI:1124639935
Name:TWINDOM COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:TWINDOM COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-359-1481
Mailing Address - Street 1:718 DORIS ST
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-1319
Mailing Address - Country:US
Mailing Address - Phone:205-359-1481
Mailing Address - Fax:
Practice Address - Street 1:319 US HWY 75
Practice Address - Street 2:SUITE B
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35951
Practice Address - Country:US
Practice Address - Phone:256-660-0796
Practice Address - Fax:256-298-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty