ALABAMA BOARD OF EXAMINERS IN COUNSELING
950 22nd Street North, Suite 765 ( Birmingham, Alabama 35203 ( (205) 458-8716 ( www.abec.alabama.gov. RENEWAL PERIOD 8/1/2019–7/31/2021 (This form may not be used after 7/31/19) LPC License #_____ I previously provided to ABEC proof of citizenship or lawful presence in U.S. Yes No . Name:_____ First Middle Last. 2. Has your name changed since last application? Yes … ................
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