| Premier Mental Health Services Llc | |
|
816 2nd St Birmingham AL 35214-5312 | |
| (205) 910-4168 | |
| Not Available |
| Full Name | Premier Mental Health Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 816 2nd St, Birmingham, Alabama |
| Authorized Official Name and Position | April Anderson Calvin (PARTNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 2059104168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Mental Health Services Llc Po Box 311655 Birmingham AL 35231-1655 Ph: (205) 910-4168 | Premier Mental Health Services Llc 816 2nd St Birmingham AL 35214-5312 Ph: (205) 910-4168 |
| NPI Number | 1043766009 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 8123467610 |
|---|---|
| Medicare Enrollment ID | O20240417000411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043766009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2557 (Alabama) | Primary |
| Provider Name | Kristi Wilson Myricks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609201391 PECOS PAC ID: 2769821255 Enrollment ID: I20240417001496 |
| Provider Name | Maxine Williford Fuller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932555711 PECOS PAC ID: 3678912169 Enrollment ID: I20240502003491 |
| Provider Name | Vevelyn Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831947746 PECOS PAC ID: 7911449111 Enrollment ID: I20240603003548 |
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