SHIFAA INTELLECTUALSOUL CONSULTING (NPI# 1912559675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912559675 |
| Entity Type | Organization |
| Organization Name | SHIFAA INTELLECTUALSOUL CONSULTING |
| Practice Address |
102 Central Park Pl Selma AL 36701-7757 |
| Mailing Address |
2541 College St Montgomery AL 36106-2124 |
| Practice Telephone | 3346259617 |
| Practice Fax Number | 3343236747 |
| Mailing Telephone | 3342077657 |
| Mailing Fax Number | 3343236747 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |
| Authorized Official Name | DR. STEPHAN IDRIS MAMBAZO (PRIMARY THERAPIST/OWNER) |
| Authorized Official Telephone | 3342077657 |
| Authorized Official Credential | LICSW-PIP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| IntellectualSoul Clinical Consulting | Doing Business As Name - Organization |
| Street Address |
102 CENTRAL PARK PL |
| City | SELMA |
| State | AL |
| Zip Code | 36701-7757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114491057 | Monica Boswell Moore | Nurse Practitioner | 1015 Medical Center Parkway, Selma, AL 36701 | 2019-01-14 |
| 1649784430 | Lightfoot Chiropractic Clinic, LLC | Chiropractor | 2117 Broad Street, Selma, AL 36701 | 2017-12-01 |
| 1356883284 | Vatausha Howard | Counselor | 1017 Medical Center Parkway, Selma, AL 36701 | 2016-11-09 |
| 1366993230 | Homestead Hospice of Cahaba | Hospice, Inpatient | 3005 Citizens Parkway, Selma, AL 36701 | 2016-10-17 |
| 1497018675 | Lashana Faye Jones | Technician | 2423 A North Broad St, Selma, AL 36701 | 2012-06-21 |
| 1528222809 | Eric M. Roussell Sr. | Pharmacist | 1300 Highland Avenue, Selma, AL 36701 | 2008-07-15 |
| 1144499302 | Cecil William Fuller Sr. | Dentist | 203 Dallas Ave, Selma, AL 36701 | 2008-02-21 |
| 1184813396 | Alliance Pharmacy LLC | Pharmacy | 133 1half Broad St, Selma, AL 36701 | 2007-10-24 |
| 1376740373 | Selma City | Local Education Agency (LEA) | 2194 Broad Street, Selma, AL 36701 | 2007-07-02 |
| 1245356229 | Georgia W Rhodes | Audiologist | 2906 Citizens Pkwy, Selma, AL 36701 | 2007-03-22 |
| Find all providers in zip 36701 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144643560 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 202 Valley Ct, Selma, NC 27576-3652 | 2014-01-22 |
| 1104250620 | Little Inspirations Developmental Services | Community/Behavioral Health | 313 Gor An Farm Rd, Selma, NC 27576-6604 | 2013-09-03 |
| 1972859015 | Silltrist Solutions | Community/Behavioral Health | 200 S Pollock St Ste C, Selma, NC 27576-3062 | 2012-07-26 |
| 1649443953 | Johnston County Industries, Inc. | Community/Behavioral Health | 112 E Richardson St, Selma, NC 27576-2606 | 2008-04-08 |
| 1114331147 | Pathways To Life, Inc | Community/Behavioral Health | 1420a S Pollock St, Selma, NC 27576-3404 | 2014-06-18 |
| 1861761827 | Healthcore Resource, Inc | Community/Behavioral Health | 113 E Oak St, Selma, NC 27576-2845 | 2011-12-21 |
| 1376841668 | Carolina Support Services, Inc | Community/Behavioral Health | 200 S Pollock St, Selma, NC 27576-3062 | 2011-03-10 |
| 1881883056 | Kings View | Community/Behavioral Health | 3800 Mccall Ave, Selma, CA 93662-2217 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649886193 | The Cade Center LLC | Community/Behavioral Health | 2601 County Road 45, Lisman, AL 36912-2764 | 2020-09-21 |
| 1326652785 | Perfect Imperfections Behavioral Health Services LLC | Community/Behavioral Health | 1829 Princeton Ct Sw, Birmingham, AL 35211-2430 | 2020-09-03 |
| 1740893346 | Phoenix Community Support Services LLC | Community/Behavioral Health | 4111 Avenue L, Birmingham, AL 35208-1807 | 2020-08-25 |
| 1124639935 | Twindom Counseling Services, LLC | Community/Behavioral Health | 202 Lackey Street, Boaz, AL 35957 | 2020-08-14 |
| 1902414972 | Brenda Chynoweth LLC | Community/Behavioral Health | 703 E Glenn Ave Ste D, Auburn, AL 36830-5016 | 2020-07-16 |
| 1821619453 | Abilities Unlimited LLC | Community/Behavioral Health | 1761 Wire Rd Apt 4-7, Auburn, AL 36832-6645 | 2020-05-05 |
| 1811517147 | Paths To Empowerment Counseling Services, LLC | Community/Behavioral Health | 7850 Country Dr, Mobile, AL 36619-5325 | 2020-04-16 |
| 1659904258 | The Solace Group | Community/Behavioral Health | 8129 Jackson Ave, Leeds, AL 35094-1480 | 2020-02-21 |
| 1083253504 | The Dallas Maryland Wellness Group, LLC | Community/Behavioral Health | 882 Plantation Way Ste E, Montgomery, AL 36117-2217 | 2020-01-01 |
| 1629617444 | Haven Counseling Services of Cullman, LLC | Community/Behavioral Health | 18291 Us Hwy 31, Cullman, AL 35058 | 2019-12-26 |
| Find all providers with the same taxonomy | ||||
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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.