NPIMap

Organization Active NPI

Convergence Free Will Intervention

Doing business as Behavioral Health

  • Professional Counselor
  • Gadsden, AL
National Provider Identifier
1407310766
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CONVERGENCE FREE WILL INTERVENTION
Doing business as
Behavioral Health
Practice address
303 S 11TH St
Gadsden, AL 35901-3507
Phone
(256) 478-1182
NPI assigned
Jan 30, 2019
Last updated
Jan 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Authorized official

Name
Theresa R Scott, ALCNPI 1275028144
Title
MSPC- Solo Proprietor
Phone
(256) 478-1182

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X Primary
Cognitive & Behavioral Psychologist 103TB0200X
Group Psychotherapy Psychologist 103TP2701X

Addresses

Primary practice location

303 S 11TH St
Gadsden, AL 35901-3507

Mailing address

1205 Gardner St
Gadsden, AL 35901-3040
Phone (256) 478-1182

Other names 1

  • Behavioral Health Doing business as

National Provider Directory

National Provider Directory

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": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1407310766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GARDNER ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359013040",
            "telephone_number": "256-478-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S 11TH ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359013507",
            "telephone_number": "256-478-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVERGENCE FREE WILL INTERVENTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MSPC- SOLO PROPRIETOR",
        "authorized_official_telephone_number": "256-478-1182",
        "authorized_official_credential": "ALC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.