Organization
WELLFRONT READINESS SOLUTIONS
Active
Other names
WellFront Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER STICKLE M.ED., LPCC (DIR. FIELD OPS)
(502) 418-3469
Entity
Organization
Contact information
Practice address
207 PARKER DR UNIT 2B, LA GRANGE, KY 40031-1269
(502) 418-3469
Mailing address
1206 BURNT HILL RD, GOSHEN, KY 40026-9553
(502) 418-3469
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
KY
101YM0800X
Mental Health Counselor
Primary
1243
KY
101YP2500X
Professional Counselor
1243
KY
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
KY
253J00000X
Foster Care Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
KY
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
01/30/2018
Last updated
06/16/2018
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