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General NPI Number Information
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NPI Number | 1942953252
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Entity Type | Organization
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Legal Business Name | FORTUNE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 7150 CAHABA VALLEY RD STE 201
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City | BIRMINGHAM
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State | AL
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Zip | 35242-6697
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Country | US
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Telephone | 205-492-4096
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Fax |
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Provider Business Mailing Address
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Address Line | P O BOX 36702 1809 RIVERCHASE DRIVE
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City | HOOVER
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State | AL
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Zip | 35236
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Country | US
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Telephone | 205-471-7767
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIVICA FORTUNE
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Credential |
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Telephone | 205-492-4096
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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 |
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License Number State |
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