Provider Demographics
NPI:1396285987
Name:CAHABA PSYCHIATRY AND WELLNESS, LLC
Entity type:Organization
Organization Name:CAHABA PSYCHIATRY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-504-4290
Mailing Address - Street 1:4268 CAHABA HEIGHTS CT STE 110
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5711
Mailing Address - Country:US
Mailing Address - Phone:205-504-4290
Mailing Address - Fax:
Practice Address - Street 1:4268 CAHABA HEIGHTS CT STE 110
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5711
Practice Address - Country:US
Practice Address - Phone:205-504-4290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25555261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health