Provider Demographics
NPI:1144843368
Name:KAIROS COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:KAIROS COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:334-546-8261
Mailing Address - Street 1:230 MENDEL PKWY E STE E
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-5404
Mailing Address - Country:US
Mailing Address - Phone:334-546-8261
Mailing Address - Fax:334-659-1645
Practice Address - Street 1:230 MENDEL PKWY E STE E
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-5404
Practice Address - Country:US
Practice Address - Phone:334-546-8261
Practice Address - Fax:334-659-1645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)