Provider Demographics
NPI:1144693771
Name:DESTINY THERAPEUTIC SOLUTIONS
Entity type:Organization
Organization Name:DESTINY THERAPEUTIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUTHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-601-9222
Mailing Address - Street 1:13 OFFICE PARK CIR STE 9
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2520
Mailing Address - Country:US
Mailing Address - Phone:205-601-9222
Mailing Address - Fax:
Practice Address - Street 1:13 OFFICE PARK CIR STE 9
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2520
Practice Address - Country:US
Practice Address - Phone:205-601-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health