Healthcare Provider Details

I. General information

NPI: 1104579705
Provider Name (Legal Business Name): SPARROW COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 CENTRAL AVE STE 305
BIRMINGHAM AL
35209-2576
US

IV. Provider business mailing address

2917 CENTRAL AVE STE 305
BIRMINGHAM AL
35209-2576
US

V. Phone/Fax

Practice location:
  • Phone: 205-538-3978
  • Fax:
Mailing address:
  • Phone: 205-538-3978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARA DUNGAN
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC, LMFT
Phone: 205-538-3978