Healthcare Provider Details

I. General information

NPI: 1003724782
Provider Name (Legal Business Name): PEACEFUL HEARTS AND MINDS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25565 LEVIE DAVIS DR
ELKMONT AL
35620-5672
US

IV. Provider business mailing address

25565 LEVIE DAVIS DR
ELKMONT AL
35620-5672
US

V. Phone/Fax

Practice location:
  • Phone: 256-867-3787
  • Fax: 256-474-8801
Mailing address:
  • Phone: 256-867-3787
  • Fax: 256-474-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA PERY
Title or Position: THERAPIST
Credential: LPC
Phone: 256-867-3787