| Name: | Croswell Counseling Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 May 2020 (4 years ago) |
| Entity Number: | 000-632-150 |
| Register Number: | 000632150 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Registered Office Street Address: | 117 STARVIEW CIRCLEALABASTER, AL 35007 |
| Registered Office Street Address ZIP Code: | 35007 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023631173 | 2020-05-24 | 2020-05-24 | 117 STAR VIEW CIR, ALABASTER, AL, 350078539, US | 731 MIDDLE ST, MONTEVALLO, AL, 351153730, US | |||||||||||||||||||
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| Phone | +1 601-416-6295 |
Authorized person
| Name | DUSTY CROSWELL |
| Role | OWNER |
| Phone | 6014166295 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1134504186 |
| State | AL |
| Name | Role |
|---|---|
| CROSWELL, DUSTY | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
