| NPI | 1265072219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE BRASHEAR Credentialing/ Billing Manager 859-300-1437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2025-07-30 |