Organization
CONVERGENCE FREE WILL INTERVENTION
Active
Other names
Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA R SCOTT ALC (MSPC- SOLO PROPRIETOR)
(256) 478-1182
Entity
Organization
Contact information
Practice address
303 S 11TH ST, GADSDEN, AL 35901-3507
(256) 478-1182
Mailing address
1205 GARDNER ST, GADSDEN, AL 35901-3040
(256) 478-1182
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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