Organization
YELLOW SAGE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LACEFIELD (MANAGING MEMBER)
(270) 317-1318
Entity
Organization
Contact information
Practice address
562 N DIXIE BLVD STE B4, RADCLIFF, KY 40160-1366
(270) 317-1318
Mailing address
1019 FAIRVIEW AVE, RADCLIFF, KY 40160-2407
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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