Healthcare Provider Details

I. General information

NPI: 1053479584
Provider Name (Legal Business Name): JAMES C. ABSHIRE LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 DOTHAN RD
ABBEVILLE AL
36310-2836
US

IV. Provider business mailing address

1841 HONEYSUCKLE RD
DOTHAN AL
36305-4269
US

V. Phone/Fax

Practice location:
  • Phone: 334-585-5331
  • Fax: 334-585-5965
Mailing address:
  • Phone: 334-712-1170
  • Fax: 334-712-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2020
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: