Organization
MANDALA THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SMITH LCSW (OWNER)
(606) 388-2898
Entity
Organization
Contact information
Practice address
1201 SAINT CHRISTOPHER DR, ASHLAND, KY 41101-7064
(606) 388-2898
Mailing address
1201 SAINT CHRISTOPHER DR, ASHLAND, KY 41101-7064
(606) 388-2898
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/21/2019
Last updated
03/06/2025
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