Provider Demographics
NPI:1982159596
Name:MDC COUNSELING, LLC
Entity Type:Organization
Organization Name:MDC COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:DEANNA
Authorized Official - Last Name:CAUDLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:931-265-1747
Mailing Address - Street 1:250 CHATEAU DR SW STE 145
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6437
Mailing Address - Country:US
Mailing Address - Phone:256-801-8937
Mailing Address - Fax:256-517-8355
Practice Address - Street 1:250 CHATEAU DR SW STE 145
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6437
Practice Address - Country:US
Practice Address - Phone:256-801-8937
Practice Address - Fax:256-517-8355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3021251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health