Individual provider Active NPI

Patricia A Bristow, LCSW

  • Clinical Social Worker
  • Huntsville, AL
National Provider Identifier
1053513374
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1862C Issued in AL
Practice address
607 McCullough Ave NE
Huntsville, AL 35801-6342
Phone
(256) 655-7577
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1862C AL Primary

Addresses

Primary practice location

607 McCullough Ave NE
Huntsville, AL 35801-6342

Mailing address

105 Tahoe Cir
Harvest, AL 35749-9628
Phone (256) 655-7577

Other names 1

  • Patricia A Courtney Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 15, 2025 through Oct 15, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1862CALMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053513374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 TAHOE CIR",
            "city": "HARVEST",
            "state": "AL",
            "postal_code": "357499628",
            "telephone_number": "256-655-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 MCCULLOUGH AVE NE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016342",
            "telephone_number": "256-655-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOW",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1862C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "COURTNEY",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.