Organization
HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY LYNN MATTINGLY LPCC (OWNER)
(270) 402-5601
Entity
Organization
Contact information
Practice address
106 CEMETERY RD, LEBANON, KY 40033-1827
(270) 401-1104
Mailing address
106 CEMETERY RD, LEBANON, KY 40033-1827
(270) 401-1104
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPCPCC00223155
KY
253Z00000X
In Home Supportive Care Agency
—
KY
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
11/02/2016
Last updated
12/17/2020
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