Tabia Keonna Woolfork Recreational Mental Health Fitness Facility

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TABIA KEONNA WOOLFORK RECREATIONAL MENTAL HEALTH FITNESS FACILITY

Practice address

853 S Court St
Montgomery, AL 36104-4905

Phone

(334) 647-1880

NPI assigned

Jul 25, 2022

Organization subpart

No

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

Authorized official

Name

Peggie Lee Hatten, ALCNPI 1568123578

Title

Founder

Phone

(334) 647-1880

Specialties & licenses 1

Addresses

Other names 1

• TABIA KEONNA WOOLFORK RECREATIONAL MENTAL HEALTH FITNESS FACILITY Former legal business name

Electronic endpoints 1

Locations

Practitioners 1

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

• Peggie Lee Hatten, BA, MD, SAC,

  • Addiction (Substance Use Disorder) Counselor
  • Montgomery, AL
  • NPI 1568123578
  NPD Authorized official

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1639805500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6021 PORTSMOUTH CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361167103",
            "telephone_number": "334-538-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 S COURT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361044905",
            "telephone_number": "334-647-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABIA KEONNA WOOLFORK RECREATIONAL MENTAL HEALTH FITNESS FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "HATTEN",
        "authorized_official_first_name": "PEGGIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "334-647-1880",
        "authorized_official_credential": "ALC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tkwmh@yahoo.com",
            "affiliation": "N",
            "address_1": "853 S Court St",
            "city": "Montgomery",
            "state": "AL",
            "country_code": "US",
            "postal_code": "361044905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "TABIA KEONNA WOOLFORK RECREATIONAL MENTAL HEALTH FITNESS FACILITY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tamara Marshaye Swinton
• Swisher Chiropractic
• Alyssa Bryanna Swisher, DC
• Zahra Syed, MD
• Anil Synghal, MD
• Maria Rosario Tanate Tabino, MD
• Numair Tahir, DO
• Tai Q Chung MD
• Felicia Taite, BSN-RN
• Ernestine B Takang, CRNP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.