1265810097 NPI number — MS. CONNIE LOUISE ALBRIGHT LICSW

Table of content: MS. CONNIE LOUISE ALBRIGHT LICSW (NPI 1265810097)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265810097 NPI number — MS. CONNIE LOUISE ALBRIGHT LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBRIGHT
Provider First Name:
CONNIE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUGHEY
Provider Other First Name:
CONNIE
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265810097
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
750 MORPHY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRHOPE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36532-1812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-279-1119
Provider Business Mailing Address Fax Number:
251-279-1117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 MORPHY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRHOPE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36532-1812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-279-1119
Provider Business Practice Location Address Fax Number:
251-279-1117
Provider Enumeration Date:
05/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  4447C , 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)





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