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General NPI Number Information
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NPI Number | 1649710997
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Entity Type | Organization
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Legal Business Name | THE REFINERY COUNSELING & CONSULTING SERVICES
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 201 BEACON PKWY W STE 110
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3139
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Country | US
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Telephone | 205-777-1716
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Fax | 205-449-6450
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Provider Business Mailing Address
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Address Line | 201 BEACON PKWY W STE 110
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3139
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Country | US
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Telephone | 205-777-1716
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Fax | 205-449-6450
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | TAMARA BONCIA BLACKEDGE BURR
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Credential | LCSW
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Telephone | 205-777-1716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3674C
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License Number State | AL
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