Healthcare Provider Details

I. General information

NPI: 1366806325
Provider Name (Legal Business Name): RESTORATION COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 2ND AVE NW
CULLMAN AL
35058-0464
US

IV. Provider business mailing address

2014 2ND AVE NW
CULLMAN AL
35058-0464
US

V. Phone/Fax

Practice location:
  • Phone: 256-735-8152
  • Fax: 888-255-4996
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC2487A
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: STACY DENNEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 256-735-8152