Individual
JUSTIN DAVID PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAMFC, NCC, ALC
Contact information
Practice address
3396 MOUNT OLIVE RD, MOUNT OLIVE, AL 35117-3710
(205) 631-4126
(205) 631-4156
Mailing address
554 WHITTAKER PL, LEEDS, AL 35094-4928
(678) 779-8739
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C2365A
AL
101YM0800X
Mental Health Counselor
Primary
3758
AL
101YM0800X
Mental Health Counselor
C2365A
AL
101YP2500X
Professional Counselor
C2365A
AL
Other
Enumeration date
07/06/2017
Last updated
03/17/2018
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