| Milestones Psychology And Therapy Inc | |
|
100 Westside Dr. Dothan AL 36303 | |
| (334) 793-2237 | |
| (334) 712-6256 |
| Full Name | Milestones Psychology And Therapy Inc |
|---|---|
| Speciality | Counselor |
| Location | 100 Westside Dr., Dothan, Alabama |
| Authorized Official Name and Position | Richard Dismukes (PRESIDENT) |
| Authorized Official Contact | 3347932237 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milestones Psychology And Therapy Inc 100 Westside Dr. Dothan AL 36303 Ph: (334) 793-2237 | Milestones Psychology And Therapy Inc 100 Westside Dr. Dothan AL 36303 Ph: (334) 793-2237 |
| NPI Number | 1730431164 |
|---|---|
| Provider Enumeration Date | 10/09/2012 |
| Last Update Date | 04/27/2023 |
| Certification Date | 04/27/2023 |
| Medicare PECOS PAC ID | 1052566718 |
|---|---|
| Medicare Enrollment ID | O20130301000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730431164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (Alabama) | Secondary |
| 101YP2500X | Counselor - Professional | (Alabama) | Primary |
| Provider Name | Leslie Mathis |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1811482920 PECOS PAC ID: 1254679509 Enrollment ID: I20190211003044 |
| Provider Name | Cameron Powe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073004248 PECOS PAC ID: 7113353590 Enrollment ID: I20200203001627 |
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