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General NPI Number Information
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NPI Number | 1881188928
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Entity Type | Organization
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Legal Business Name | COUNSELING CONSULTATION SERVICES
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 4800 WHITESPORT CIR SW STE 2
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6443
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Country | US
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Telephone | 256-533-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 BROOK HOLLOW CIR NW
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City | HUNTSVILLE
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State | AL
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Zip | 35816-1505
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Country | US
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Telephone | 256-337-2772
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MRS. GRACE A ARNOLD
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Credential | LPC
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Telephone | 256-337-2772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1905
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License Number State | AL
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