Healthcare Provider Details

I. General information

NPI: 1740448398
Provider Name (Legal Business Name): ADULT & CHILD DEVELOPMENT PROFESSIONALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 OFFICE PARK CIRCLE SUITE 206
BIRMINGHAM AL
35223
US

IV. Provider business mailing address

6 OFFICE PARK CIRCLE SUITE 206
BIRMINGHAM AL
35223
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-9276
  • Fax: 205-933-9280
Mailing address:
  • Phone: 205-933-9276
  • Fax: 205-933-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURIAN J SMITH
Title or Position: OFFICE MANAGER
Credential:
Phone: 205-933-9276