Healthcare Provider Details

I. General information

NPI: 1194637405
Provider Name (Legal Business Name): THE MENTAL SPACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 COLUMBIANA RD
VESTAVIA HILLS AL
35216-2139
US

IV. Provider business mailing address

2081 COLUMBIANA RD
VESTAVIA HILLS AL
35216-2139
US

V. Phone/Fax

Practice location:
  • Phone: 205-772-1301
  • Fax:
Mailing address:
  • Phone: 205-772-1301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY SHELTON
Title or Position: OWNER/MANAGING MEMBER
Credential: LPC
Phone: 205-772-1301