Healthcare Provider Details

I. General information

NPI: 1417972233
Provider Name (Legal Business Name): INDEPENDENT COUNSELING & ASSESSMENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 JAMES DR SUITE A
ENTERPRISE AL
36330-2063
US

IV. Provider business mailing address

1275 JAMES DR SUITE A
ENTERPRISE AL
36330-2063
US

V. Phone/Fax

Practice location:
  • Phone: 334-308-1940
  • Fax: 334-308-1942
Mailing address:
  • Phone: 334-308-1940
  • Fax: 334-308-1942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. BONNIE M ADKINS
Title or Position: CFO
Credential:
Phone: 334-308-1940