Organization
LAKE CUMBERLAND COMMUNITY ACTION AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH DAVENPORT (FINANCE DIRECTOR)
(270) 343-4600
Entity
Organization
Contact information
Practice address
9321 RUSSELL SPRINGS RD, RUSSELL SPRINGS, KY 42642-7713
(270) 343-4600
Mailing address
PO BOX 830, JAMESTOWN, KY 42629-0830
(270) 343-4600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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