Healthcare Provider Details

I. General information

NPI: 1043351836
Provider Name (Legal Business Name): FAMILY COUNSELING CENTER OF MOBILE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 OAK CIRCLE DR E
MOBILE AL
36609
US

IV. Provider business mailing address

PO BOX 91068
MOBILE AL
36691
US

V. Phone/Fax

Practice location:
  • Phone: 251-602-0909
  • Fax: 251-660-2831
Mailing address:
  • Phone: 251-602-0909
  • Fax: 251-660-2831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHANDRA BROWN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 251-602-0909