Provider Demographics
NPI:1215989629
Name:ALSABROOK, TOM S (LPC)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:S
Last Name:ALSABROOK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MYCHAEL LN
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35042-4446
Mailing Address - Country:US
Mailing Address - Phone:334-683-9957
Mailing Address - Fax:334-683-4114
Practice Address - Street 1:104 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AL
Practice Address - Zip Code:36756-2304
Practice Address - Country:US
Practice Address - Phone:334-683-9957
Practice Address - Fax:334-683-4114
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6291847OtherUBH BASIC SERVICES
AL6292847OtherUBH PLUS SERVICES