# CARDINAL BEHAVIORAL HEALTH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366112823
- **Authorized official:** JOELLEN MARION (PRESIDENT)
- **Authorized official phone:** (270) 202-8669

## Contact information

- **Practice address:** 719 DISHMAN LANE EXT APT C, BOWLING GREEN, KY 42104-4072
- **Practice address phone:** (270) 202-8669
- **Practice address fax:** (270) 200-8781
- **Mailing address:** 719 DISHMAN LANE EXT APT C, BOWLING GREEN, KY 42104-4072
- **Mailing address phone:** (270) 202-8669
- **Mailing address fax:** (270) 200-8781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103G00000X | Clinical Neuropsychologist | — | NULL | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2021
- **Last updated:** 11/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100886940 | — | KY |