Healthcare Provider Details

I. General information

NPI: 1679365928
Provider Name (Legal Business Name): MAPLE PSYCHIATRY AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CENTURY PARK S STE 102
BIRMINGHAM AL
35226-3922
US

IV. Provider business mailing address

PO BOX 43566
BIRMINGHAM AL
35243-0566
US

V. Phone/Fax

Practice location:
  • Phone: 205-381-4383
  • Fax: 888-394-6742
Mailing address:
  • Phone: 205-381-4383
  • Fax: 888-394-6742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICK CONAN TAPIA
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 205-381-4383