Provider Demographics
NPI:1427755792
Name:JOHNSON, ALISON CREIGHTON
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:CREIGHTON
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:CHAPMAN
Other - Last Name:CREIGHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ALC
Mailing Address - Street 1:1 PERIMETER PARK S STE 100N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3248
Mailing Address - Country:US
Mailing Address - Phone:205-936-2356
Mailing Address - Fax:205-273-5033
Practice Address - Street 1:1 PERIMETER PARK S STE 100N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3248
Practice Address - Country:US
Practice Address - Phone:205-936-2356
Practice Address - Fax:205-273-5033
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC4148A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL252005Medicaid