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General NPI Number Information
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NPI Number | 1538926415
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Entity Type | Organization
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Legal Business Name | SWEETWATER COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 509 N MAIN ST
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City | TUSCUMBIA
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State | AL
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Zip | 35674-2048
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Country | US
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Telephone | 256-272-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 509 N MAIN ST
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City | TUSCUMBIA
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State | AL
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Zip | 35674-2048
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Country | US
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Telephone | 256-272-1065
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMY DAVIS
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Credential | PHD, LPC, SB-RPT
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Telephone | 256-272-1065
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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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