Provider Demographics
NPI:1285798595
Name:PRICE, JAMES TIMOTHY (LPC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:TIMOTHY
Last Name:PRICE
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 1:279 W MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-1656
Mailing Address - Country:US
Mailing Address - Phone:334-794-7887
Mailing Address - Fax:
Practice Address - Street 1:279 W MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1656
Practice Address - Country:US
Practice Address - Phone:334-794-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0795101YP2500X
AL164106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist