Healthcare Provider Details

I. General information

NPI: 1083548218
Provider Name (Legal Business Name): CCM COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 AVENUE A
OPELIKA AL
36801-5061
US

IV. Provider business mailing address

226 LEE DR
AUBURN AL
36832-6722
US

V. Phone/Fax

Practice location:
  • Phone: 334-728-9555
  • Fax:
Mailing address:
  • Phone: 334-728-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN COLEY MILLER
Title or Position: LICSW
Credential: LICSW
Phone: 334-728-9555