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General NPI Number Information
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NPI Number | 1629983671
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Entity Type | Individual
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Provider Name | JUSTIN LATODD HACKETT ALC
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Gender | Male
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Dates
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Enumeration Date | 08/15/2026
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Last Update Date | 08/15/2026
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Provider Practice Location Address
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Address Line | 1530 3RD AVE N
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City | BESSEMER
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State | AL
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Zip | 35020-5775
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Country | US
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Telephone | 205-795-3410
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Fax |
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Provider Business Mailing Address
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Address Line | 5285 BRIDLE PATH LN
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City | PINSON
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State | AL
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Zip | 35126-6432
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Country | US
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Telephone | 205-541-0047
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Fax |
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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 | ALC06140
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License Number State | AL
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