DR. ANNIE L FORMWALT (NPI# 1861696759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861696759 |
Entity Type | Individual |
Full Name | DR. ANNIE L FORMWALT |
Credential | PSY.D. |
Practice Address |
Po Box 850818 Mobile AL 36685-0818 |
Mailing Address |
7305 Cottage Hill Rd Mobile AL 36695-2829 |
Practice Telephone | 2517761217 |
Practice Fax Number | 2517761219 |
Mailing Telephone | 2517761217 |
Mailing Fax Number | 2517761219 |
Enumeration Date | 2007-06-13 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
504 | AL | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AL | BLUE CROSS AND BLUE SHIEL | 51071147 | 01 |
Street Address |
PO BOX 850818 |
City | MOBILE |
State | AL |
Zip Code | 36685-0818 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558565440 | Lucile T Williams | Psychologist | Po Box 850818, Mobile, AL 36685-0818 | 2007-06-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972944601 | Bruce Lowman,md LLC | General Acute Care Hospital | 6801 Airport Blvd, Mobile, AL 36685 | 2013-07-10 |
1518132299 | David Randolph Vial | Clinical Nurse Specialist | 3719 Dauphin St., Springhill Hosp. Medicalcenter-anestheia Dept, Mobile, AL 36685-1417 | 2008-04-24 |
1427496587 | Fleur De Lis Operations LLC | Clinic/Center | 6157 Airport Blvd, Suite 852022, Mobile, AL 36685-5501 | 2013-06-11 |
1003254160 | John Herron | Occupational Therapist | 6157 Airport Blvd, Suite 852022, Mobile, AL 36685-5501 | 2013-06-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184225989 | Helen Mcgill Guthrie | Social Worker | 1701 Government St, Mobile, AL 36604-1103 | 2020-11-06 |
1093316259 | University of South Alabama Health Care Authority | Internal Medicine | 2503 Old Shell Rd, Mobile, AL 36607-3021 | 2020-11-04 |
1235730862 | Tips Love LLC | Nurse's Aide | 4167 Shan Dr E, Mobile, AL 36693-4856 | 2020-11-02 |
1457951063 | Courtney Hall | Home Health Aide | 3223 Spring Hill Ave, Mobile, AL 36607-1809 | 2020-11-01 |
1316547763 | Jacquelyn Keller | Massage Therapist | 3050 Meadow Ln, Mobile, AL 36618-4634 | 2020-10-26 |
1821698309 | Bhg Lxxii, LLC | Clinic/Center | 4373 Dowtowner Loop South, Suite A, Mobile, AL 36609 | 2020-10-26 |
1750980397 | Ali Marino | Marriage & Family Therapist | 1327 Spring Hill Ave, Mobile, AL 36604-3231 | 2020-10-24 |
1467051904 | Endia Vranee Bush-brooks | Technician | 10922 Sierra Estates Dr, Mobile, AL 36608-4049 | 2020-10-24 |
1629677596 | Linda Jean Hayes | Counselor | 2146 Carson Court, Mobile, AL 36695 | 2020-10-22 |
1457950123 | Shameka Manigault | Social Worker | 5566 Vanderbilt Ct, Mobile, AL 36608-3026 | 2020-10-22 |
Find all providers in MOBILE |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023581246 | Elizabeth Fair | Psychologist | 3168 Midtown Park S Ste E, Mobile, AL 36606 | 2019-01-10 |
1669887063 | Phillip Nelson Smith | Psychologist | University of South Alabama, 75 S. University Blvd., Ucom1000, Mobile, AL 36688-0001 | 2014-06-24 |
1346558285 | David Neesmith | Psychologist | 3929 Airport Blvd., Ste 2-520, Mobile, AL 36609 | 2010-09-14 |
1992965313 | Mobile Psychological, LLC | Psychologist | 2411 Old Shell Rd, Mobile, AL 36607-3019 | 2008-06-10 |
1487813804 | Danielle Andria Beech | Psychologist | 1110 Montlimar Dr Ste 500, Mobile, AL 36609-1794 | 2008-06-02 |
1558565440 | Lucile T Williams | Psychologist | Po Box 850818, Mobile, AL 36685-0818 | 2007-06-13 |
1235274002 | Jennifer Langhinrichsen-rohling | Psychologist | 307 University Blvd North, University Commons, Ste 2000, Mobile, AL 36688-0001 | 2007-02-20 |
1992842629 | Celina Rebecca Guisinger | Psychologist | 4332 Boulevard Park S Ste A, Mobile, AL 36609-3423 | 2007-01-31 |
1215081914 | Laura Goulden | Psychologist | 2450 Old Shell Rd # A, Mobile, AL 36607-3020 | 2007-01-22 |
1184775736 | Jason (jake) Epker | Psychologist | 2450a Old Shell Rd, Mobile, AL 36607-3020 | 2007-01-12 |
Find all providers in MOBILE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.