Healthcare Provider Details

I. General information

NPI: 1992504898
Provider Name (Legal Business Name): OASIS PSYCHIATRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 LEE RD 380
VALLEY AL
36854
US

IV. Provider business mailing address

120 19TH ST N STE 201
BIRMINGHAM AL
35203-3219
US

V. Phone/Fax

Practice location:
  • Phone: 706-590-8188
  • Fax:
Mailing address:
  • Phone: 706-590-8188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. HEATHER BENSON CROWDER-KALLA
Title or Position: PMHNP- BC
Credential: NP
Phone: 706-590-8188