Provider Demographics
NPI:1801509856
Name:FORTIFY CHRISTIAN COUNSELING, LLC
Entity type:Organization
Organization Name:FORTIFY CHRISTIAN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:THREADCRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-677-6067
Mailing Address - Street 1:140 PIN OAK DR
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-5213
Mailing Address - Country:US
Mailing Address - Phone:205-677-6067
Mailing Address - Fax:
Practice Address - Street 1:4958 VALLEYDALE RD STE 250
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-7723
Practice Address - Country:US
Practice Address - Phone:205-677-6067
Practice Address - Fax:205-588-0786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty