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General NPI Number Information
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NPI Number | 1619605953
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Entity Type | Organization
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Legal Business Name | FLOURISH PSYCHOTHERAPY SERVICES, LLC
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Dates
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Enumeration Date | 08/14/2022
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Last Update Date | 08/14/2022
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Provider Practice Location Address
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Address Line | 1260 DAUPHIN ST STE 111
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City | MOBILE
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State | AL
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Zip | 36604-2546
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Country | US
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Telephone | 251-554-2075
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Fax |
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Provider Business Mailing Address
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Address Line | 11910 JESSE JACKSON DR
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City | MOBILE
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State | AL
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Zip | 36608-9020
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Country | US
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Telephone | 251-554-2075
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | MS. MARY BARRETT SMITH
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Credential | MSW, LICSW-PIP
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Telephone | 251-554-2075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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