Heather Surber Licsw Llc | |
9238 Madison Blvd Ste 116 Madison AL 35758-9112 | |
(256) 542-3288 | |
(256) 542-3289 |
Full Name | Heather Surber Licsw Llc |
---|---|
Speciality | Community/Behavioral Health |
Location | 9238 Madison Blvd Ste 116, Madison, Alabama |
Authorized Official Name and Position | Heather Lynn Surber (OWNER) |
Authorized Official Contact | 2565423288 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Heather Surber Licsw Llc 9238 Madison Blvd Ste 116 Madison AL 35758-9112 Ph: (256) 542-3288 | Heather Surber Licsw Llc 9238 Madison Blvd Ste 116 Madison AL 35758-9112 Ph: (256) 542-3288 |
NPI Number | 1699442764 |
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Provider Enumeration Date | 08/26/2021 |
Last Update Date | 08/26/2021 |
Certification Date | 08/26/2021 |
Medicare PECOS PAC ID | 6709275142 |
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Medicare Enrollment ID | O20211105000990 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699442764 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Heather L Surber |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467580688 PECOS PAC ID: 3173616059 Enrollment ID: I20151103001696 |
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