Healthcare Provider Details

I. General information

NPI: 1972479103
Provider Name (Legal Business Name): CAROL CRAIN MS LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1449 MEDICAL PARK DR
BIRMINGHAM AL
35213-1901
US

IV. Provider business mailing address

60 RIDGEWOOD LN
ODENVILLE AL
35120-4758
US

V. Phone/Fax

Practice location:
  • Phone: 205-767-5438
  • Fax:
Mailing address:
  • Phone: 205-767-5438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2326
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: