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General NPI Number Information
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NPI Number | 1073948394
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Entity Type | Organization
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Legal Business Name | CARING CONFIDENTIAL COUNSLEING, LLC
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Dates
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Enumeration Date | 09/05/2013
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 3480 BROAD STREET
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City | PHIL CAMPBELL
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State | AL
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Zip | 35581-6141
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Country | US
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Telephone | 205-993-4556
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Fax | 205-993-4556
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Provider Business Mailing Address
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Address Line | 287 MON DYE RD
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City | PHIL CAMPBELL
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State | AL
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Zip | 35581-6141
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Country | US
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Telephone | 205-993-4556
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Fax | 205-993-4556
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Authorized Official
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Title or Position | OWNER
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Name | LISA L FORMAN
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Credential | LCSW,PIP
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Telephone | 205-993-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | AL
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