Healthcare Provider Details

I. General information

NPI: 1689449167
Provider Name (Legal Business Name): ALABAMA INSTITUTE FOR BEHAVIORAL HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 RIVERCHASE DR STE 100A
PHENIX CITY AL
36867-7497
US

IV. Provider business mailing address

5009 RIVERCHASE DR STE 100A
PHENIX CITY AL
36867-7497
US

V. Phone/Fax

Practice location:
  • Phone: 334-408-4689
  • Fax: 334-408-2100
Mailing address:
  • Phone: 334-408-4689
  • Fax: 334-408-2100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN MICHAEL DUFFEY I
Title or Position: EXECUTIVE DIRECTOR
Credential: MACC
Phone: 334-408-4689