| Etowah Dekalb Cherokee Mental Health Board, Inc | |
|
425 5th Ave Nw Attalla AL 35954-2214 | |
| (256) 492-7800 | |
| (256) 494-5536 |
| Full Name | Etowah Dekalb Cherokee Mental Health Board, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 425 5th Ave Nw, Attalla, Alabama |
| Authorized Official Name and Position | Shelia Hurley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2564927800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Etowah Dekalb Cherokee Mental Health Board, Inc 425 5th Ave Nw Attalla AL 35954-2214 Ph: (256) 492-7800 | Etowah Dekalb Cherokee Mental Health Board, Inc 425 5th Ave Nw Attalla AL 35954-2214 Ph: (256) 492-7800 |
| NPI Number | 1326175795 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 08/01/2024 |
| Certification Date | 08/01/2024 |
| Medicare PECOS PAC ID | 3678628427 |
|---|---|
| Medicare Enrollment ID | O20090901000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326175795 | NPI | - | NPPES |
| 590000012 | Medicaid | AL | |
| 330034012 | Medicaid | AL | |
| 330000012 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Huma Khusro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104929587 PECOS PAC ID: 5698867737 Enrollment ID: I20070822000319 |
| Provider Name | Richard E Grant |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790942571 PECOS PAC ID: 8921177320 Enrollment ID: I20090724000592 |
| Provider Name | Leesha M Ellis Cox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598764698 PECOS PAC ID: 0749235406 Enrollment ID: I20100617000551 |
| Provider Name | Sarah Gilreath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134485386 PECOS PAC ID: 7810151024 Enrollment ID: I20120619000233 |
| Provider Name | Jenia R Fowler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760049530 PECOS PAC ID: 4587990791 Enrollment ID: I20190725002596 |
| Provider Name | Kasey D Gross Vickery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992944607 PECOS PAC ID: 8325427347 Enrollment ID: I20220622002316 |
Seasons Counseling & Consulting Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 309 Case Ave Se, Attalla, AL 35954 Phone: 256-393-9431 | |
Grace Counseling & Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 306 7th Ave Nw, Attalla, AL 35954 Phone: 256-295-7402 |