Healthcare Provider Details

I. General information

NPI: 1447178587
Provider Name (Legal Business Name): COMMUNITY RESILIENCE COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 WOODS COVE RD STE B
SCOTTSBORO AL
35768-4930
US

IV. Provider business mailing address

521 WOODS COVE RD STE B
SCOTTSBORO AL
35768-4930
US

V. Phone/Fax

Practice location:
  • Phone: 256-223-7270
  • Fax: 256-223-7271
Mailing address:
  • Phone: 256-223-7270
  • Fax: 256-223-7271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. JORDAN COOPER
Title or Position: DIRECTOR
Credential: LPC
Phone: 256-223-7270