Healthcare Provider Details

I. General information

NPI: 1073948394
Provider Name (Legal Business Name): CARING CONFIDENTIAL COUNSLEING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 09/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 BROAD STREET
PHIL CAMPBELL AL
35581-6141
US

IV. Provider business mailing address

287 MON DYE RD
PHIL CAMPBELL AL
35581-6141
US

V. Phone/Fax

Practice location:
  • Phone: 205-993-4556
  • Fax: 205-993-4556
Mailing address:
  • Phone: 205-993-4556
  • Fax: 205-993-4556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LISA L FORMAN
Title or Position: OWNER
Credential: LCSW,PIP
Phone: 205-993-4556