Healthcare Provider Details

I. General information

NPI: 1841675865
Provider Name (Legal Business Name): KOLBE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 FOOTHILLS PKWY STE 113
CHELSEA AL
35043-8236
US

IV. Provider business mailing address

109 FOOTHILLS PKWY STE 113
CHELSEA AL
35043-8236
US

V. Phone/Fax

Practice location:
  • Phone: 205-618-9899
  • Fax: 205-618-9706
Mailing address:
  • Phone: 205-618-9899
  • Fax: 205-618-9706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM CARL WAINSCOTT II
Title or Position: CEO
Credential:
Phone: 205-618-9899