| Name: | Anna H Wilson, LICSW, PIP, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Oct 2021 (3 years ago) |
| Entity Number: | 000-949-560 |
| Register Number: | 000949560 |
| County: | Jefferson |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 4268 CAHABA HEIGHTS COURTBIRMINGHAM, AL 35243 |
| Registered Office Street Address ZIP Code: | 35243 |
| Registered Office Mailing Address: | 3050 TERESA AVENUEHUEYTOWN, AL 35023 |
| Registered Office Mailing Address ZIP Code: | 35023 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669131199 | 2021-12-13 | 2021-12-13 | 3050 TERESA AVE, HUEYTOWN, AL, 350233043, US | 4268 CAHABA HEIGHTS CT STE 132, VESTAVIA, AL, 352435737, US | |||||||||||||||||
|
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| Phone | +1 205-616-9953 |
Authorized person
| Name | ANNA H WILSON |
| Role | SOLE OWNER AND OPERATOR |
| Phone | 2056169953 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1922024064 |
| Name | Role |
|---|---|
| ANNA H WILSON | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
