Organization
CLINICAL COUNSELING PRACTICE, PLLC
Active
Other names
Clinical Consulting Practice, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JIMALEE Y ROSS LCSW (DIRECTOR)
(606) 495-5478
Entity
Organization
Contact information
Practice address
525 MAIN ST, WEST LIBERTY, KY 41472-1015
(606) 495-5478
Mailing address
123 PLEASANT VIEW LN, EZEL, KY 41425-8522
(606) 495-5478
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3019
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376698167
INDIVIDUAL NPI
KY
Enumeration date
07/18/2007
Last updated
07/18/2007
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