Organization Active NPI

Counseling Associates of Montgomery

  • Mental Health Counselor
  • Montgomery, AL
National Provider Identifier
1518431675
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
COUNSELING ASSOCIATES OF MONTGOMERY
Practice address
1623 Forest Avenue
Montgomery, AL 36106-1541
Phone
(334) 201-7477
Fax
(334) 676-1575
NPI assigned
Jan 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Authorized official

Name
Mr. Robbie Mangum, LPCNPI 1447661087
Title
Ceo
Phone
(334) 201-7477

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1623 Forest Avenue
Montgomery, AL 36106-1541

Mailing address

1623 Forest Avenue
Montgomery, AL 36106-1541
Phone (334) 201-7477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260526002857 AL Part B Supplier - Clinic/Group Practice 4284104787 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, AL

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.

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1518431675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 FOREST AVENUE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061541",
            "telephone_number": "334-201-7477",
            "fax_number": "334-676-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 FOREST AVENUE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061541",
            "telephone_number": "334-201-7477",
            "fax_number": "334-676-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ASSOCIATES OF MONTGOMERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "ROBBIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-201-7477",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jan 11, 2019; 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.