Provider Demographics
NPI:1982373189
Name:WITHERSPOON, TWARNER (LMSW)
Entity Type:Individual
Prefix:
First Name:TWARNER
Middle Name:
Last Name:WITHERSPOON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TWARNER
Other - Middle Name:
Other - Last Name:WITHERSPOON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1631 MALLARD CIR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-5544
Mailing Address - Country:US
Mailing Address - Phone:205-331-6956
Mailing Address - Fax:
Practice Address - Street 1:5330 STADIUM TRACE PKWY STE 106
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4526
Practice Address - Country:US
Practice Address - Phone:205-861-6419
Practice Address - Fax:205-860-8950
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5506C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker