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General NPI Number Information
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NPI Number | 1225912884
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Entity Type | Organization
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Legal Business Name | COMFORT PLACE CHRISTIAN COUNSELING LLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 2101 EXECUTIVE PARK DR STE 102
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City | OPELIKA
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State | AL
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Zip | 36801-6198
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Country | US
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Telephone | 256-794-2593
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Fax | 256-794-2593
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Provider Business Mailing Address
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Address Line | 2101 EXECUTIVE PARK DR STE 102
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City | OPELIKA
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State | AL
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Zip | 36801-6198
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Country | US
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Telephone | 256-794-2593
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DONNA JACKSON
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Credential | LICSW
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Telephone | 256-794-2593
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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 |
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