Provider Demographics
NPI:1528614591
Name:THERAPY VILLAGE LLC
Entity type:Organization
Organization Name:THERAPY VILLAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANYELLE
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-710-9790
Mailing Address - Street 1:2081 FLORENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2751
Mailing Address - Country:US
Mailing Address - Phone:256-710-9790
Mailing Address - Fax:
Practice Address - Street 1:2081 FLORENCE BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2751
Practice Address - Country:US
Practice Address - Phone:256-710-9790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty