Provider Demographics
NPI:1508682121
Name:MOUNTAIN VALLEY COUNSELING, LLC
Entity type:Organization
Organization Name:MOUNTAIN VALLEY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:BIRDSONG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-382-8550
Mailing Address - Street 1:731 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:MONTEVALLO
Mailing Address - State:AL
Mailing Address - Zip Code:35115-3730
Mailing Address - Country:US
Mailing Address - Phone:205-382-8550
Mailing Address - Fax:205-382-8550
Practice Address - Street 1:731 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:MONTEVALLO
Practice Address - State:AL
Practice Address - Zip Code:35115-3730
Practice Address - Country:US
Practice Address - Phone:205-382-8550
Practice Address - Fax:205-382-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty