Organization
WARREN BEHAVIORAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNELLE WARREN (CLINICAL PSYCHOLOGIST)
(334) 808-8991
Entity
Organization
Contact information
Practice address
201 REGENCY CT, DOTHAN, AL 36305-1179
(334) 673-8869
Mailing address
201 REGENCY CT, DOTHAN, AL 36305-1179
(334) 673-8869
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3455
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051532779
MEDICARE
AL
01
—
51532779
BLUE CROSS AND BLUE SHIELD
AL
05
—
529927710
—
AL
Enumeration date
10/14/2015
Last updated
10/14/2015
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