Healthcare Provider Details

I. General information

NPI: 1306767769
Provider Name (Legal Business Name): MIDDLE GROUND MENTAL WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 EAGLE POINT CORPORATE DR
BIRMINGHAM AL
35242-6986
US

IV. Provider business mailing address

274 GRANDE VIEW PKWY
MAYLENE AL
35114-6073
US

V. Phone/Fax

Practice location:
  • Phone: 205-855-2240
  • Fax: 205-855-2340
Mailing address:
  • Phone: 205-451-5995
  • 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 StateNULL

VIII. Authorized Official

Name: MS. KATHERINE K THEURI
Title or Position: CRNP
Credential: NP
Phone: 205-451-5995