Provider Demographics
NPI:1790373744
Name:COUNSELING SOLUTIONS OF EAST AL, LLC
Entity type:Organization
Organization Name:COUNSELING SOLUTIONS OF EAST AL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:CLEONE
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:334-444-0754
Mailing Address - Street 1:648 SHELTON WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-2948
Mailing Address - Country:US
Mailing Address - Phone:334-444-0754
Mailing Address - Fax:334-539-1999
Practice Address - Street 1:648 SHELTON WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-2948
Practice Address - Country:US
Practice Address - Phone:334-444-0754
Practice Address - Fax:334-539-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)