Provider Demographics
NPI:1275000549
Name:WOODRUFF, DANA CLARK (LPC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:CLARK
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 DECATUR AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35208-1306
Mailing Address - Country:US
Mailing Address - Phone:205-447-4111
Mailing Address - Fax:
Practice Address - Street 1:208 23RD ST N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-3819
Practice Address - Country:US
Practice Address - Phone:205-452-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3163A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist