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General NPI Number Information
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NPI Number | 1588750459
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Entity Type | Organization
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Legal Business Name | LAURELTREE FAMILY & ACADEMIC COUNSELING SERVICES INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 1058 N MAIN ST
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City | ARAB
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State | AL
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Zip | 35016-7000
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Country | US
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Telephone | 256-677-1092
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Fax | 256-586-6715
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Provider Business Mailing Address
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Address Line | 1947 PINE LAKE DR NW
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City | ARAB
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State | AL
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Zip | 35016-4535
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Country | US
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Telephone | 256-677-1092
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Fax | 256-586-6715
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOE R. CREEL
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Credential | LCSW, LPC, MA
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Telephone | 256-677-1092
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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 | 538
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License Number State | AL
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