Healthcare Provider Details

I. General information

NPI: 1700599677
Provider Name (Legal Business Name): CAHABA MARRIAGE AND FAMILY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 PROVIDENCE PARK STE 250
BIRMINGHAM AL
35242-4694
US

IV. Provider business mailing address

1401 PROVIDENCE PARK STE 250
BIRMINGHAM AL
35242-4694
US

V. Phone/Fax

Practice location:
  • Phone: 205-623-4863
  • Fax: 205-449-9844
Mailing address:
  • Phone: 205-623-4863
  • Fax: 205-449-9844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELLERY COOK BERRYHILL
Title or Position: PARTNER/CO-OWNER
Credential: LPC, LMFT
Phone: 205-623-4863