Healthcare Provider Details

I. General information

NPI: 1932136645
Provider Name (Legal Business Name): DAVID BOND LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5906 CARMICHAEL PLACE
MONTGOMERY AL
36117
US

IV. Provider business mailing address

2430 FAIRLANE DR C-7
MONTGOMERY AL
36116-1641
US

V. Phone/Fax

Practice location:
  • Phone: 334-409-9090
  • Fax: 334-409-9669
Mailing address:
  • Phone: 334-551-0735
  • Fax: 334-551-0767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0151
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: