Healthcare Provider Details

I. General information

NPI: 1326080003
Provider Name (Legal Business Name): THE SAMARITAN COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 ZELDA RD
MONTGOMERY AL
36106-2648
US

IV. Provider business mailing address

2911 ZELDA RD
MONTGOMERY AL
36106-2648
US

V. Phone/Fax

Practice location:
  • Phone: 334-262-7787
  • Fax: 334-262-7795
Mailing address:
  • Phone: 334-262-7787
  • Fax: 334-262-7795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE ADELE NIXON
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 334-262-7787