MEDICARE: IN TOUCH COUNSELING AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2557	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1821364829	OTHER	AL	BLUE CROSS BLUE SHIELD OF ALABAMA

General Provider Information

NPI Number	:	1750862934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN TOUCH COUNSELING AGENCY

Provider Business Mailing Address
First Line	:	1562 WILDERNESS LN
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-2854
Country	:	US
Telephone Number	:	205-910-4168
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 3RD AVE N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35203-1628
Country	:	US
Telephone Number	:	205-910-4168
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	APRIL CALVIN
Credential	:	LPC
Telephone Number	:	205-910-4168

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	08/24/2018

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