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General NPI Number Information
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NPI Number | 1326423781
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL MEDICINE LLC
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 05/24/2018
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Provider Practice Location Address
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Address Line | 8104 SEATON PL
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City | MONTGOMERY
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State | AL
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Zip | 36116
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Country | US
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Telephone | 334-272-3889
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Fax | 334-272-4089
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Provider Business Mailing Address
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Address Line | 8104 SEATON PL
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City | MONTGOMERY
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State | AL
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Zip | 36116-7204
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Country | US
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Telephone | 334-272-3889
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Fax | 334-272-4089
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. HERMAN W BEACHAM
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Credential |
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Telephone | 334-272-3889
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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 | AL
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