Basic Information
| Provider Information | |||||||||
| NPI: | 1235397985 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPLETE FAMILY PASTORAL COUNSELING, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 959 | ||||||||
| Address2: | |||||||||
| City: | PELHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351240959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056850373 | ||||||||
| FaxNumber: | 2056850393 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 PELHAM PKWY | ||||||||
| Address2: | |||||||||
| City: | PELHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351241705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056850373 | ||||||||
| FaxNumber: | 2956850393 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2008 | ||||||||
| LastUpdateDate: | 05/29/2008 | ||||||||
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| AuthorizedOfficialLastName: | MCKEEVERE | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2056850373 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | PH.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 386 LPC | AL | Y | Agencies | Community/Behavioral Health |
No ID Information.