Individual
MR. ALBERT ODELL CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ACADC, CPS
Contact information
Practice address
5705 LONG MEADOW COURT, MOBILE, AL 36609
(850) 529-3434
Mailing address
5705 LONG MEADOW CT, MOBILE, AL 36609-7017
(850) 529-3434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
05R076
IA
101YA0400X
Addiction (Substance Use Disorder) Counselor
1381
MS
101YA0400X
Addiction (Substance Use Disorder) Counselor
AD05-020C
MS
101YM0800X
Mental Health Counselor
339002147
AL
101YP2500X
Professional Counselor
—
—
171M00000X
Case Manager/Care Coordinator
339002147
AL
174400000X
Specialist
P04-003C
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339002147
—
AL
05
—
339049174
—
AL
Enumeration date
08/24/2007
Last updated
01/30/2009
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