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General NPI Number Information
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NPI Number | 1285204461
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Entity Type | Organization
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Legal Business Name | AFFINITY COUNSELING, LLC
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 14368 HIGHWAY 43 STE 1
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City | RUSSELLVILLE
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State | AL
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Zip | 35653-2569
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Country | US
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Telephone | 256-291-7221
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Fax |
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Provider Business Mailing Address
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Address Line | 14368 HIGHWAY 43 STE 1
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City | RUSSELLVILLE
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State | AL
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Zip | 35653-2569
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Country | US
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Telephone | 256-291-7221
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MICHELLE BOLTON
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Credential | LPC-S
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Telephone | 256-291-7221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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