Healthcare Provider Details

I. General information

NPI: 1043302672
Provider Name (Legal Business Name): LAURA WHITWORTH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SOUTH 19TH STREET 116 - MENTAL HEALTH
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

700 SOUTH 19TH STREET 116 - MENTAL HEALTH
BIRMINGHAM AL
35233
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-8101
  • Fax: 205-939-4585
Mailing address:
  • Phone: 205-933-8101
  • Fax: 205-939-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number639
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number639
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number639
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number639
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number639
License Number StateAL
# 6
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number639
License Number StateAL
# 7
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number639
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: