# SOUTHERN KENTUCKY THERAPEUTIC INTERVENTIONS AND BEHAVIOR HEALTH SERVIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Ky Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104668920
- **Authorized official:** MELISSA MCINTOSH LCSW (OWNER)
- **Authorized official phone:** (606) 392-3958

## Contact information

- **Practice address:** 319 JOHNNY DR, SCIENCE HILL, KY 42553-9146
- **Practice address phone:** (606) 392-3958
- **Mailing address:** 319 JOHNNY DR, SCIENCE HILL, KY 42553-9146
- **Mailing address phone:** (606) 392-3958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2024
- **Last updated:** 06/11/2024