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Organization

BIRCHWOOD HEALING PLACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORETTA LYNN GILMORE MSW, LCSW (LICENSED CLINICAL SOCIAL WORK / OWN)
(859) 312-6569
Entity
Organization

Contact information

Practice address
1050 CHINOE RD STE 112, LEXINGTON, KY 40502-6571
(859) 312-6569
(855) 594-5062
Mailing address
1050 CHINOE RD STE 112, LEXINGTON, KY 40502-6571
(859) 312-6569
(855) 594-5062

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100422750
KY
05
7100958780
KY
Enumeration date
10/12/2018
Last updated
10/16/2024
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