Organization
ICU COUNSELING AND MENTAL HEALTH SUPPORT SERVICES, LLC
Active
Other names
ICU Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIUS SMITH (OWNER)
(251) 545-9659
Entity
Organization
Contact information
Practice address
3351 MOFFETT RD, MOBILE, AL 36607-1713
(251) 423-4014
Mailing address
350 STUDENT CENTER CIR U3715, MOBILE, AL 36688-0001
(251) 545-9659
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/23/2021
Last updated
01/08/2025
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