Healthcare Provider Details

I. General information

NPI: 1255959169
Provider Name (Legal Business Name): MICHAEL BRANDON HOOPER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SOUTHLAND DR STE 232
VESTAVIA AL
35226-3735
US

IV. Provider business mailing address

405 BELCHER ST
CENTREVILLE AL
35042-2946
US

V. Phone/Fax

Practice location:
  • Phone: 205-260-1014
  • Fax:
Mailing address:
  • Phone: 205-926-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05054
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: