Provider Demographics
NPI:1396835468
Name:POPE, LOIS H (PHD)
Entity type:Individual
Prefix:DR
First Name:LOIS
Middle Name:H
Last Name:POPE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4800 WHITESPORT CIR SW
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6444
Mailing Address - Country:US
Mailing Address - Phone:256-533-9393
Mailing Address - Fax:256-533-9690
Practice Address - Street 1:4800 WHITESPORT CIR SW
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6444
Practice Address - Country:US
Practice Address - Phone:256-533-9393
Practice Address - Fax:256-533-9690
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL737103T00000X, 103TC0700X, 103TC2200X, 103TF0000X, 103TF0200X, 103TH0100X, 103TM1800X, 103TP2701X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51074427OtherBLUE CROSS BLUE SHIELD
ALR37122Medicare UPIN
AL00074427Medicare ID - Type Unspecified