NPIMap

Organization Active NPI

Board of Trustees, University of Alabama

Doing business as UA Autism Spectrum Disorder Clinic

  • Psychologist
  • Tuscaloosa, AL
National Provider Identifier
1265736888
Registry record updated Dec 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BOARD OF TRUSTEES, UNIVERSITY OF ALABAMA
Doing business as
UA Autism Spectrum Disorder Clinic
Practice address
651 5TH Ave E
CDRD Room 262
Tuscaloosa, AL 35401-7424
Phone
(205) 348-3130
Fax
(205) 348-7216
NPI assigned
Dec 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2010

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

Authorized official

Name
Michelle Hawthorne
Title
Credentialing Coordinator
Phone
(205) 348-1262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

651 5TH Ave E
CDRD Room 262
Tuscaloosa, AL 35401-7424

Mailing address

PO Box 870360
Tuscaloosa, AL 35487-0360
Phone (205) 348-3130

Other names 1

  • UA Autism Spectrum Disorder Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capstone Rural Health C12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

651 Peter Bryce Blvd
Rm 262
Tuscaloosa, AL 35401
Phone (205) 348-3130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293062400000",
    "number": "1265736888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 870360",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354870360",
            "telephone_number": "205-348-3130",
            "fax_number": "205-348-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 5TH AVE E",
            "address_2": "CDRD ROOM 262",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017424",
            "telephone_number": "205-348-3130",
            "fax_number": "205-348-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF TRUSTEES, UNIVERSITY OF ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-23",
        "last_updated": "2010-12-23",
        "status": "A",
        "authorized_official_last_name": "HAWTHORNE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "205-348-1262"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UA Autism Spectrum Disorder Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; 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.