Healthcare Provider Details

I. General information

NPI: 1598683740
Provider Name (Legal Business Name): ALYSSA WHITTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6869 5TH AVE S
BIRMINGHAM AL
35212-1866
US

IV. Provider business mailing address

8704 SUNSET DR
LEEDS AL
35094-1612
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-2098
  • Fax:
Mailing address:
  • Phone: 205-405-4602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC05681
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: