Provider Demographics
NPI:1902061377
Name:PAUL COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PAUL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SHAREHOLDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:PAUL-STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, MAC, EAP
Authorized Official - Phone:334-308-3206
Mailing Address - Street 1:3950 RUCKER BLVD
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-8771
Mailing Address - Country:US
Mailing Address - Phone:334-308-3206
Mailing Address - Fax:334-308-3206
Practice Address - Street 1:3950 RUCKER BLVD
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-8771
Practice Address - Country:US
Practice Address - Phone:334-308-3206
Practice Address - Fax:334-308-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12328251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health