Provider Demographics
NPI:1518850239
Name:BIRMINGHAM PSYCHIATRY AND BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:BIRMINGHAM PSYCHIATRY AND BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:LONG
Authorized Official - Suffix:III
Authorized Official - Credentials:CRNP
Authorized Official - Phone:256-601-2335
Mailing Address - Street 1:2129 RICHARD ARRINGTON JR BLVD S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2129 RICHARD ARRINGTON JR BLVD S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1256
Practice Address - Country:US
Practice Address - Phone:256-601-2335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty