1851652234 NPI number — ATLAS SERVICES, INC.

Table of content: (NPI 1851652234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851652234 NPI number — ATLAS SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLAS SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JERRY M. MOTT, M. S., LPC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851652234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1140 SHILOH CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36609-3069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-380-0215
Provider Business Mailing Address Fax Number:
251-304-1113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 OFFICE PARK STE 305
Provider Second Line Business Practice Location Address:
273 AZALEA ROAD
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36609-1970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-380-0215
Provider Business Practice Location Address Fax Number:
251-304-1113
Provider Enumeration Date:
06/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MOTT
Authorized Official First Name:
JERRY
Authorized Official Middle Name:
MARK
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
251-380-0215

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  1557 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51028546MOT . This is a "BLUECROSS BLUESHIELD OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1557 . This is a "LICENSED PROFESSIONAL COUNSELOR" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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