Provider Demographics
NPI:1982119079
Name:DOUGLAS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:DOUGLAS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LPC-S
Authorized Official - Phone:205-266-1375
Mailing Address - Street 1:205 20TH ST N STE 410
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-4704
Mailing Address - Country:US
Mailing Address - Phone:205-266-1375
Mailing Address - Fax:205-449-0040
Practice Address - Street 1:205 20TH ST N STE 410
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-4704
Practice Address - Country:US
Practice Address - Phone:205-266-1375
Practice Address - Fax:205-449-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1043616915Medicaid