Healthcare Provider Details

I. General information

NPI: 1245696327
Provider Name (Legal Business Name): ELANA PARKER MERRIWEATHER ED.S., LPC, NCC, DCD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 MCGEHEE RD
MONTGOMERY AL
36111
US

IV. Provider business mailing address

PO BOX 11087
MONTGOMERY AL
36111-0087
US

V. Phone/Fax

Practice location:
  • Phone: 334-280-3349
  • Fax: 334-356-1426
Mailing address:
  • Phone: 334-280-3349
  • Fax: 334-356-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberAADC-017
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3269
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: