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General NPI Number Information
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NPI Number | 1497453898
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Entity Type | Individual
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Provider Name | BRIAN PATRICK KANE JR. MA, ALC, LPC
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Gender | Male
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1615 KATHY LN SW STE 102
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City | DECATUR
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State | AL
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Zip | 35603-1026
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Country | US
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Telephone | 256-701-5651
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Fax | 256-429-9411
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Provider Business Mailing Address
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Address Line | 600 SUN TEMPLE DR
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City | MADISON
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State | AL
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Zip | 35758-8643
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Country | US
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Telephone | 256-975-4291
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Fax | 256-325-1890
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | ALC04412
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License Number State | AL
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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 | 5511
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License Number State | AL
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