Provider Demographics
NPI:1366931446
Name:SALTER, NATHAN ANDREW (LICSW)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:ANDREW
Last Name:SALTER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 BECKHAM DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1719
Mailing Address - Country:US
Mailing Address - Phone:850-326-2437
Mailing Address - Fax:
Practice Address - Street 1:1553 BECKHAM DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-1719
Practice Address - Country:US
Practice Address - Phone:850-326-2437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4154C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty