Psychiatry 280 Counseling Services Inc

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

1048511 Issued in AL

Legal business name

PSYCHIATRY 280 COUNSELING SERVICES INC

Practice address

2803 Greystone Commercial Blvd Ste 12
Birmingham, AL 35242-9603

Phone

(205) 968-1227

Fax

(205) 968-1229

NPI assigned

Jul 23, 2015

Organization subpart

No

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

Authorized official

Name

Lane Gould-Hartline, APRN

Title

Provider/Owner

Phone

(205) 968-1227

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

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

• Mary Lane Gould-Hartline, APRN BC CEDS

  • Psychiatry Physician
  • Hoover, AL
  • NPI 1255387213
  Medicare reassignment NPD
• John R Langlow III, MD

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1285680942
  Medicare reassignment
• Samuel Andrew Polek, M.D.

  • Psychiatry Physician
  • Clarksville, TN
  • NPI 1790004646
  NPD (past)

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1285019927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 GREYSTONE COMMERCIAL BLVD STE 12",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352429603",
            "telephone_number": "205-968-1227",
            "fax_number": "205-968-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 GREYSTONE COMMERCIAL BLVD STE 12",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352429603",
            "telephone_number": "205-968-1227",
            "fax_number": "205-968-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY 280 COUNSELING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "GOULD-HARTLINE",
        "authorized_official_first_name": "LANE",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "205-968-1227",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1048511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynsey Pruitt
• Stephanie Pruitt
• Valencia M Pruitt, LMSW
• Ashley Przybysz, MD
• Ashley Y Pston, M.S. CCC-SLP
• Psychiatry 280, P.C. (PolekMD)
• Psychiatry Associates, PC
• Psychiatry South, Inc.
• Psychnet Systems
• Psychological Care Services of Al, LLC

• Psychiatric/Mental Health Clinical Nurse Specialist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.