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NPI Code Detail

MEDICARE: FORTIFY CHRISTIAN COUNSELING, LLC

MEDICARE: FORTIFY CHRISTIAN COUNSELING, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP1600XPastoral Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1801509856
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORTIFY CHRISTIAN COUNSELING, LLC
Provider Business Mailing Address
First Line : 140 PIN OAK DR
Second Line :
City : CHELSEA
State : AL
Zip : 35043-5213
Country : US
Telephone Number : 205-677-6067
Fax Number :
Provider Business Practice Location Address
First Line : 4958 VALLEYDALE RD STE 250
Second Line :
City : HOOVER
State : AL
Zip : 35242-7723
Country : US
Telephone Number : 205-677-6067
Fax Number : 205-588-0786
Authorized Official
Title or Position : FOUNDER
Name : MR. JOHN THREADCRAFT
Credential : LPC
Telephone Number : 205-677-6067
Provider Enumeration Date : 01/04/2023
Last Update Date : 01/04/2023

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Directions to “FORTIFY CHRISTIAN COUNSELING, LLC ” Practice Location

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