Individual provider Active NPI

Catrece Dantzler

  • Counselor
  • Montgomery, AL
National Provider Identifier
1306266895
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3252 Issued in AL
Practice address
4560 Woodley Rd
Montgomery, AL 36116-4734
Phone
(334) 467-4992
Fax
(334) 396-5896
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3252 AL Primary
Marriage & Family Therapist 106H00000X 397 AL

Addresses

Primary practice location

4560 Woodley Rd
Montgomery, AL 36116-4734

Mailing address

PO Box 231402
Montgomery, AL 36123-1402
Phone (334) 467-4992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
397ALMDPhysical Therapy Assistant
3252ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Immanuel Counseling Services, LLC Marriage & Family Therapist CurrentSince Aug 6, 2023 Accepting new patients

Locations

3104 S Railroad St
Ste B
Phenix City, AL 36867
Phone (334) 655-1414

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1306266895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231402",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361231402",
            "telephone_number": "334-467-4992",
            "fax_number": "334-396-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 WOODLEY RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361164734",
            "telephone_number": "334-467-4992",
            "fax_number": "334-396-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER",
        "first_name": "CATRECE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "3252",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AL",
            "license": "397",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.