Healthcare Provider Details

I. General information

NPI: 1508260423
Provider Name (Legal Business Name): BARKLEY COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 GLOVER AVE SUITE 3
ENTERPRISE AL
36330-2024
US

IV. Provider business mailing address

557 GLOVER AVE SUITE 3
ENTERPRISE AL
36330-2024
US

V. Phone/Fax

Practice location:
  • Phone: 334-347-1862
  • Fax: 334-347-2919
Mailing address:
  • Phone: 334-347-1862
  • Fax: 334-347-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC2118A
License Number StateAL

VIII. Authorized Official

Name: MRS. ASTRA BARKLEY
Title or Position: OWNER
Credential: ALC
Phone: 334-806-6182