Provider Demographics
NPI:1811109275
Name:FIRST BAPTIST CHURCH OF PELHAM
Entity type:Organization
Organization Name:FIRST BAPTIST CHURCH OF PELHAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-663-2779
Mailing Address - Street 1:2867 PELHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1728
Mailing Address - Country:US
Mailing Address - Phone:205-663-2779
Mailing Address - Fax:205-663-6925
Practice Address - Street 1:2867 PELHAM PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1728
Practice Address - Country:US
Practice Address - Phone:205-663-2779
Practice Address - Fax:205-663-6925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1890101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty