Healthcare Provider Details

I. General information

NPI: 1457712622
Provider Name (Legal Business Name): DR. JOSEPH G. LAW JR. & ASSOCIATES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 BEL AIR BLVD SUITE 24
MOBILE AL
36606-3528
US

IV. Provider business mailing address

605 BEL AIR BLVD SUITE 24
MOBILE AL
36606-3528
US

V. Phone/Fax

Practice location:
  • Phone: 251-450-0000
  • Fax: 186-626-7905
Mailing address:
  • Phone: 251-450-0000
  • Fax: 186-626-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number345
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP0000001064
License Number StateTN

VIII. Authorized Official

Name: DR. JOSEPH G LAW JR.
Title or Position: OWNER/COUNSELOR
Credential: LPC
Phone: 251-450-0000