Organization Active NPI

The Centre

  • Mental Health Counselor
  • Daphne, AL
National Provider Identifier
1104073592
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC 111 AL Issued in AL
Legal business name
THE CENTRE
Practice address
1290 Main St Ste E
Daphne, AL 36526-8624
Phone
(251) 625-0118
Fax
(251) 625-0116
NPI assigned
Aug 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Mr. Robert Edwin Colclough, LPC
Title
Director
Phone
(251) 625-0118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LPC 111 AL AL Primary

Addresses

Primary practice location

1290 Main St Ste E
Daphne, AL 36526-8624

Mailing address

1290 Main St Ste E
Daphne, AL 36526-8624
Phone (251) 625-0118

Other identifiers 2

IdentifierTypeStateIssuer
515 92982OtherALBLUE CROSS
515 92986OtherALBLUE CROSS ROBERT COLCLOUGH

National Provider Directory

National Provider Directory

Locations

1290 Main St
Ste E
Daphne, AL 36526
Phone (251) 625-0118

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1104073592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 MAIN ST STE E",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365268624",
            "telephone_number": "251-625-0118",
            "fax_number": "251-625-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 MAIN ST STE E",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365268624",
            "telephone_number": "251-625-0118",
            "fax_number": "251-625-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "COLCLOUGH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "251-625-0118",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "LPC 111 AL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "515 92982",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ROBERT COLCLOUGH",
            "identifier": "515 92986",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.