Healthcare Provider Details

I. General information

NPI: 1861306953
Provider Name (Legal Business Name): KIERRA NICOLE GUYTON ALLEN ALC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2046 CLUBVIEW ST
MONTGOMERY AL
36106-1625
US

IV. Provider business mailing address

1403 CROSSINGS DR
MILLBROOK AL
36054-2198
US

V. Phone/Fax

Practice location:
  • Phone: 334-322-4437
  • Fax: 334-460-9814
Mailing address:
  • Phone: 205-394-7313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06194
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: