Provider Demographics
NPI:1871245787
Name:AFFORDABLE TELEMENTAL HEALTH LLC
Entity type:Organization
Organization Name:AFFORDABLE TELEMENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CPAT, CTLC
Authorized Official - Phone:410-624-7576
Mailing Address - Street 1:234 MISTY COVE CT
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:AL
Mailing Address - Zip Code:35761-7654
Mailing Address - Country:US
Mailing Address - Phone:615-438-0992
Mailing Address - Fax:
Practice Address - Street 1:234 MISTY COVE CT
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:AL
Practice Address - Zip Code:35761-7654
Practice Address - Country:US
Practice Address - Phone:615-438-0992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty