Healthcare Provider Details

I. General information

NPI: 1154258655
Provider Name (Legal Business Name): JOSHUA THIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 DOUGLAS AVE
BREWTON AL
36426-1709
US

IV. Provider business mailing address

821 DOUGLAS AVE
BREWTON AL
36426-1709
US

V. Phone/Fax

Practice location:
  • Phone: 251-286-0707
  • Fax:
Mailing address:
  • Phone: 251-286-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC05919
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: