Andrae Jylon Perry
Individual provider Active NPI Professional Counselor · Fultondale, AL
NPI 1801484175 · NPPES record last updated Jan 4, 2021
Key facts
- NPI
- 1801484175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- C3064A (AL)
- Practice address
- 3549 Grand Central Ave
Fultondale, AL 35068-1990 - Phone
- (205) 586-8933
- NPI assigned
- Jan 4, 2021
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C3064A | AL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | C3064A | AL | Yes |
Addresses
Primary practice location
3549 Grand Central Ave
Fultondale, AL 35068-1990
Mailing address
3549 Grand Central Ave
Fultondale, AL 35068-1990
Phone (205) 586-8933
Other providers in Fultondale, AL
- Adam Ross Nortick
- Norwood Clinic, Inc
- Olympus Direct Primary Care. P.C.
- Charles Ridgeway Payne
- Jennifer Grace Peacock
- Myah Phillips
- Ladonya C. Pierce
- Princeton Home Health, LLC
- Shaheen Rajpari
- Jenifer Lynn Rasco
All providers in Fultondale, AL · Professional Counselor in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.