Provider Demographics
NPI:1811737554
Name:GORRIE, MAGNUS MILLER II (LPC)
Entity type:Individual
Prefix:MR
First Name:MAGNUS
Middle Name:MILLER
Last Name:GORRIE
Suffix:II
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 AZALEA RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2508
Mailing Address - Country:US
Mailing Address - Phone:205-504-9509
Mailing Address - Fax:
Practice Address - Street 1:2208 UNIVERSITY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2313
Practice Address - Country:US
Practice Address - Phone:205-504-9509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC05280101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional