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Organization
MENTAL HEALTH & WELLNESS CENTER, LLC
Active
Organization
MENTAL HEALTH & WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL R LOOSE (OWNER/CLINICAL THERAPIST)
(859) 241-3081
Entity
Organization
Contact information
Practice address
125 ORCHARD DR, NICHOLASVILLE, KY 40356-2690
(859) 241-3081
(859) 241-1045
Mailing address
125 ORCHARD DR, NICHOLASVILLE, KY 40356-2690
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/21/2017
Last updated
11/08/2018
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