Healthcare Provider Details

I. General information

NPI: 1518609676
Provider Name (Legal Business Name): PHASE 2 ALTERNATIVES COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 HIDDEN TRACE CT
MONTEVALLO AL
35115-5933
US

IV. Provider business mailing address

3552 PELHAM PKWY # 1016
PELHAM AL
35124-2012
US

V. Phone/Fax

Practice location:
  • Phone: 212-933-0807
  • Fax:
Mailing address:
  • Phone: 212-933-0807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. SYLVIA TAYLOR
Title or Position: COUNSELOR
Credential:
Phone: 917-536-0808