Provider Demographics
NPI:1063580694
Name:USREY, JOHN (LPC, BSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:USREY
Suffix:
Gender:M
Credentials:LPC, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5541 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36206-1465
Mailing Address - Country:US
Mailing Address - Phone:256-225-4172
Mailing Address - Fax:
Practice Address - Street 1:331 E 8TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5731
Practice Address - Country:US
Practice Address - Phone:256-236-3403
Practice Address - Fax:256-238-6263
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51075844USROtherBLUE CROSS