Provider Demographics
NPI:1194889600
Name:PSYCHOLOGICAL & COUNSELING ASSOCIATES
Entity type:Organization
Organization Name:PSYCHOLOGICAL & COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELVIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-837-2127
Mailing Address - Street 1:PO BOX 11791
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35814-1791
Mailing Address - Country:US
Mailing Address - Phone:256-837-2127
Mailing Address - Fax:
Practice Address - Street 1:936 JEFF RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1238
Practice Address - Country:US
Practice Address - Phone:256-837-2127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL657103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529908550Medicaid