| Name: | The Olive Branch Counseling Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Apr 2022 (3 years ago) |
| Entity Number: | 001-014-738 |
| Register Number: | 001014738 |
| County: | Shelby |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 405 WYNLAKES LANESALABASTER, AL 35007 |
| Registered Office Street Address ZIP Code: | 35007 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558091785 | 2022-06-11 | 2022-06-11 | 549 1ST ST N STE C, ALABASTER, AL, 350078755, US | 549 1ST ST N STE C, ALABASTER, AL, 350078755, US | |||||||||||||||||||
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| Phone | +1 205-259-8308 |
Authorized person
| Name | MRS. ERICA WILSON |
| Role | THERAPIST |
| Phone | 2052598308 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS, CIGNA, VIVA |
| Number | 8590 |
| State | AL |
| Name | Role |
|---|---|
| WILSON, ERICA | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
