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General NPI Number Information
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NPI Number | 1487262572
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Entity Type | Organization
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Legal Business Name | EPIPHANY COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 4252 CARMICHAEL RD
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City | MONTGOMERY
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State | AL
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Zip | 36106-2804
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Country | US
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Telephone | 313-213-1754
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 231672
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City | MONTGOMERY
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State | AL
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Zip | 36123-1672
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | KATHERINE PAULING
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Credential |
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Telephone | 313-213-1754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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