Provider Demographics
NPI:1326897091
Name:STAYWELL COUNSELING
Entity type:Organization
Organization Name:STAYWELL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:MEGAN
Authorized Official - Last Name:LIGHTSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:256-613-6902
Mailing Address - Street 1:1902 SUMMIT PL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3142
Mailing Address - Country:US
Mailing Address - Phone:256-613-6902
Mailing Address - Fax:
Practice Address - Street 1:250B YEAGER PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1800
Practice Address - Country:US
Practice Address - Phone:938-800-0698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical