| NPI | 1013961812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WISE CEO 270-765-2605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 80005) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 80005) |
| 101YP2500X Counselor, Professional (Licence: KY 80005) | |
| 103TC0700X Psychologist, Clinical (Licence: KY 800005) | |
| 103TC1900X Psychologist, Counseling (Licence: KY 800005) | |
| 104100000X Social Worker (Licence: KY 80005) | |
| 1041C0700X Social Worker, Clinical (Licence: KY 80005) | |
| 106H00000X Marriage & Family Therapist (Licence: KY 800005) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 800005) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2022-07-25 |