Origins Counseling and Wellness

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ORIGINS COUNSELING AND WELLNESS

Practice address

4351 Fair Meadow LN
Pike Road, AL 36064-2603

Phone

(806) 517-8339

NPI assigned

Dec 16, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Michael Dwight Hall, FACHE

Title

Managing Partner

Phone

(806) 517-8339

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1205595345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 FAIR MEADOW LN",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360642603",
            "telephone_number": "806-517-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 FAIR MEADOW LN",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360642603",
            "telephone_number": "806-517-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGINS COUNSELING AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DWIGHT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "806-517-8339",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Pike Road, AL
• Providers in Pike Road, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.