Provider Demographics
NPI:1982347985
Name:ODONNELL, NAOMI (ALC, NCC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:ODONNELL
Suffix:
Gender:F
Credentials:ALC, NCC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:ODONNELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ALC, NCC
Mailing Address - Street 1:712 47TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-3430
Mailing Address - Country:US
Mailing Address - Phone:205-601-1605
Mailing Address - Fax:
Practice Address - Street 1:701 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1847
Practice Address - Country:US
Practice Address - Phone:205-916-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3853A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health