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Organization
EARLY INTERVENTION AND CONSULTATION SERVICES, LLC
Active
Organization
EARLY INTERVENTION AND CONSULTATION SERVICES, LLC
Active
Parent organization
1780092957
Other names
EICS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
1780092957
Authorized official
MRS. LASHELL ROBIN LASHLEY M.A.E., M.A.S.E., (EXECUTIVE DIRECTOR)
(270) 868-0089
Entity
Organization
Contact information
Practice address
635 S MAIN ST STE B, LEITCHFIELD, KY 42754
(270) 287-0656
(270) 230-0328
Mailing address
635 S MAIN ST STE B, LEITCHFIELD, KY 42754-1056
(270) 287-0656
(270) 230-0328
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
KY
2080P0006X
Developmental - Behavioral Pediatrics Physician
800280
KY
251S00000X
Community/Behavioral Health Agency
800280
KY
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100267230
—
KY
05
—
7100542910
—
KY
Enumeration date
07/31/2014
Last updated
02/08/2024
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