Healthcare Provider Details

I. General information

NPI: 1245025501
Provider Name (Legal Business Name): HANOVER BEHAVIORAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 HANOVER CIR S
BIRMINGHAM AL
35205-1703
US

IV. Provider business mailing address

39 HANOVER CIR S
BIRMINGHAM AL
35205-1703
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-8677
  • Fax:
Mailing address:
  • Phone: 205-877-8677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
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: KAREN MUSGROVE
Title or Position: CEO
Credential: PHD, MED, LPC
Phone: 205-322-4197