Healthcare Provider Details
I. General information
NPI: 1780118356
Provider Name (Legal Business Name): BUILDING RESILIENCE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/20/2017
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9353 COUNTY ROAD 72
FYFFE AL
35971-3566
US
IV. Provider business mailing address
9353 COUNTY ROAD 72
FYFFE AL
35971-3566
US
V. Phone/Fax
- Phone: 256-601-7421
- Fax:
- Phone: 256-601-7421
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 1295-3928C |
| License Number State | AL |
VIII. Authorized Official
Name:
KARI
BRITT
OWENS
Title or Position: THERAPIST/OWNER
Credential: LICSW, PIP
Phone: 256-601-7421