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Organization
THERAPEUTIC VILLLAGE, LLC
Active
Organization
THERAPEUTIC VILLLAGE, LLC
Active
Other names
Therapeutic Village
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL LYNN ELAM LMFT (OWNER)
(859) 595-5860
Entity
Organization
Contact information
Practice address
19 WAINSCOTT AVE, WINCHESTER, KY 40391-1970
(859) 595-5860
(502) 808-6041
Mailing address
5580 ECTON RD, WINCHESTER, KY 40391-9626
(859) 595-5860
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/19/2015
Last updated
04/14/2016
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