| Name: | Brookwood Psychology, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Feb 2001 (24 years ago) (Companies founded in February 2001) |
| Entity Number: | 000-673-996 |
| Register Number: | 000673996 |
| ZIP code: | 35209 (Companies in Jefferson, 35209) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2018 BROOKWOOD MEDICAL CENTER DR STE 311HOMEWOOD, AL 35209 |
Activities
PROVIDE PSYCHOLOGICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699946053 | 2008-03-13 | 2018-01-17 | 3037 MASSEY RD, VESTAVIA, AL, 352163603, US | 3037 MASSEY RD, VESTAVIA, AL, 352163603, US | |||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
| Phone | +1 205-874-9805 |
| Fax | 2058749806 |
Authorized person
| Name | DR. JOEL D MELVIN |
| Role | OWNER |
| Phone | 2058749805 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | 799 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | US DEPARTMENT OF LABOR |
| Number | 300177100 |
| State | AL |
| Issuer | UPIN |
| Number | S18031 |
| State | AL |
| Issuer | BLUE CROSS |
| Number | 051099592 |
| State | AL |
| Name | Role |
|---|---|
| MELVIN, JOEL D | Agent |
| Name | Role |
|---|---|
| MELVIN, JOEL D | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
