Provider Demographics
NPI:1891667994
Name:CULTIVATE CLINICAL COUNSELING, LLC
Entity type:Organization
Organization Name:CULTIVATE CLINICAL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATTIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:256-640-6870
Mailing Address - Street 1:531 COUNTY ROAD 1819
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-2860
Mailing Address - Country:US
Mailing Address - Phone:256-640-6870
Mailing Address - Fax:
Practice Address - Street 1:1310 2ND AVE NW STE C
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-1703
Practice Address - Country:US
Practice Address - Phone:256-640-6870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty