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Anna H Wilson, LICSW, PIP, LLC

Details

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) (Companies founded in October 2021)
Entity Number: 000-949-560
Register Number: 000949560
ZIP code: 35243 (Companies in Jefferson, 35243)
County: Jefferson
Place of Formation: Alabama
Registered Office Street Address: 4268 CAHABA HEIGHTS COURTBIRMINGHAM, AL 35243
Registered Office Mailing Address: 3050 TERESA AVENUEHUEYTOWN, AL 35023

National Provider Identifier

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

Contacts

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

Agent

Name Role
ANNA H WILSON Agent

Date of last update: 17 Aug 2024

Sources: Alabama Secretary of State