Albert Odell Cheatham, MS, ACADC, CPS

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mobile, AL

NPI 1376736157 · NPPES record last updated Jan 30, 2009

Key facts

NPI
1376736157
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
05R076 (IA)
Practice address
5705 Long Meadow Court
Mobile, AL 36609
Phone
(850) 529-3434
NPI assigned
Aug 24, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
05R076IAMDAddiction (Substance Use Disorder) Counselor
AD05-020CMSMDAddiction (Substance Use Disorder) Counselor
1381MSMDProfessional Counselor
339002147ALMDCase Manager/Care Coordinator
P04-003CMSMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X AD05-020C MS
Addiction (Substance Use Disorder) Counselor 101YA0400X 1381 MS
Addiction (Substance Use Disorder) Counselor 101YA0400X 05R076 IA Yes
Mental Health Counselor 101YM0800X 339002147 AL
Professional Counselor 101YP2500X
Case Manager/Care Coordinator 171M00000X 339002147 AL
Specialist 174400000X P04-003C MS

Addresses

Primary practice location

5705 Long Meadow Court
Mobile, AL 36609

Mailing address

5705 Long Meadow CT
Mobile, AL 36609-7017
Phone (850) 529-3434

Other identifiers

IdentifierTypeStateIssuer
339002147MedicaidAL
339049174MedicaidAL

Other providers in Mobile, AL

All providers in Mobile, AL · Addiction (Substance Use Disorder) Counselor in Alabama

Sources for this page

Verify at the official NPI Registry.