Healthcare Provider Details

I. General information

NPI: 1902799901
Provider Name (Legal Business Name): CALLIE GRACE LEDFORD ALC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
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

2700 US-280 S SUITE 246E
MOUNTAIN BROOK AL
35223
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: