Healthcare Provider Details

I. General information

NPI: 1780344804
Provider Name (Legal Business Name): TERESA PRINCE MA, LPC, NCC, BCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CAHABA PARK CIR STE 214
BIRMINGHAM AL
35242-8113
US

IV. Provider business mailing address

200 CAHABA PARK CIR STE 214
BIRMINGHAM AL
35242-8113
US

V. Phone/Fax

Practice location:
  • Phone: 205-903-6282
  • Fax:
Mailing address:
  • Phone: 205-903-6282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC3881A
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05000
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: