Organization
CARDINAL BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOELLEN MARION (PRESIDENT)
(270) 202-8669
Entity
Organization
Contact information
Practice address
719 DISHMAN LANE EXT APT C, BOWLING GREEN, KY 42104-4072
(270) 202-8669
(270) 200-8781
Mailing address
719 DISHMAN LANE EXT APT C, BOWLING GREEN, KY 42104-4072
(270) 202-8669
(270) 200-8781
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100886940
—
KY
Enumeration date
09/16/2021
Last updated
11/15/2024
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