Basic Information
| Provider Information | |||||||||
| NPI: | 1043380215 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH ALABAMA COUNSELING CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1001 | ||||||||
| Address2: | |||||||||
| City: | GUNTERSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565828880 | ||||||||
| FaxNumber: | 2565828890 | ||||||||
| Practice Location | |||||||||
| Address1: | 1612 RAILROAD AVE | ||||||||
| Address2: | |||||||||
| City: | GUNTERSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565828880 | ||||||||
| FaxNumber: | 2565828890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 01/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | COOKE | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | MORRISON | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2565828880 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LPC LMFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
No ID Information.