| Btac | |
|
2100 Southbridge Pkwy Ste 650 Birmingham AL 35209-1317 | |
| (205) 206-6977 | |
| (205) 533-9265 |
| Full Name | Btac |
|---|---|
| Speciality | Counselor |
| Location | 2100 Southbridge Pkwy Ste 650, Birmingham, Alabama |
| Authorized Official Name and Position | Lasheena Davis (OWNER/PROVIDER) |
| Authorized Official Contact | 2052066977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Btac 2100 Southbridge Pkwy Ste 650 Birmingham AL 35209-1317 Ph: (205) 206-6977 | Btac 2100 Southbridge Pkwy Ste 650 Birmingham AL 35209-1317 Ph: (205) 206-6977 |
| NPI Number | 1346839073 |
|---|---|
| Provider Enumeration Date | 01/17/2021 |
| Last Update Date | 01/19/2023 |
| Certification Date | 01/19/2023 |
| Medicare PECOS PAC ID | 0749633626 |
|---|---|
| Medicare Enrollment ID | O20240126002228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346839073 | NPI | - | NPPES |
| Provider Name | Lasheena Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275084196 PECOS PAC ID: 1658724539 Enrollment ID: I20240126002295 |
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