Healthcare Provider Details

I. General information

NPI: 1215844220
Provider Name (Legal Business Name): PAYTON ELAINE WASHINGTON ALC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 HAMPSTEAD HIGH ST STE 200
MONTGOMERY AL
36116-6789
US

IV. Provider business mailing address

2201 VAUGHN LAKES BLVD APT 2812
MONTGOMERY AL
36117-4157
US

V. Phone/Fax

Practice location:
  • Phone: 334-647-1047
  • Fax: 256-364-2144
Mailing address:
  • Phone: 205-764-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06165
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: