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General NPI Number Information
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NPI Number | 1578804480
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Entity Type | Organization
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Legal Business Name | VALLEY PSYCHIATRIC ASSOCIATES, P.C.
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 1615 KATHY LN SW
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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 | 256-306-4128
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Fax | 256-432-2015
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Provider Business Mailing Address
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Address Line | PO BOX 2240
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City | DECATUR
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State | AL
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Zip | 35609-2240
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Country | US
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Telephone | 256-306-4128
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Fax | 256-432-2015
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT LESTER SPRINKLE III
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Credential | M.D.
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Telephone | 256-306-4128
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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 | 2290
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 904
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0678-1798C
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 21792
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License Number State | AL
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