Provider Demographics
NPI:1992494041
Name:ACTON, BRANCH (LICSW)
Entity type:Individual
Prefix:
First Name:BRANCH
Middle Name:
Last Name:ACTON
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 MONTCLAIR RD STE 206
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2418
Mailing Address - Country:US
Mailing Address - Phone:205-919-1902
Mailing Address - Fax:205-278-5304
Practice Address - Street 1:3918 MONTCLAIR RD STE 206
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-2418
Practice Address - Country:US
Practice Address - Phone:205-919-1902
Practice Address - Fax:205-278-5304
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5347C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical