Provider Demographics
NPI:1295285203
Name:TUSCALOOSA CENTER FOR COGNITIVE THERAPY
Entity type:Organization
Organization Name:TUSCALOOSA CENTER FOR COGNITIVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:VAUGHANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:334-201-9146
Mailing Address - Street 1:815 GARDEN PKWY
Mailing Address - Street 2:APT 537
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-3871
Mailing Address - Country:US
Mailing Address - Phone:334-201-9146
Mailing Address - Fax:
Practice Address - Street 1:3518 LOOP RD
Practice Address - Street 2:SUITE 4
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5421
Practice Address - Country:US
Practice Address - Phone:334-201-9146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008350261QM0801X
ALAL2921261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)