Provider Demographics
NPI:1427639079
Name:INFORMED COUNSELING, LLC
Entity type:Organization
Organization Name:INFORMED COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:GREGSON
Authorized Official - Last Name:SPAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, PIP
Authorized Official - Phone:205-213-3409
Mailing Address - Street 1:12039 OLDE SOUTH LN
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-2335
Mailing Address - Country:US
Mailing Address - Phone:205-213-3409
Mailing Address - Fax:
Practice Address - Street 1:12039 OLDE SOUTH LN
Practice Address - Street 2:
Practice Address - City:MC CALLA
Practice Address - State:AL
Practice Address - Zip Code:35111-2335
Practice Address - Country:US
Practice Address - Phone:205-213-3409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health