Organization
MOONBEAU COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN LARSON (LICENSED PROFESSIONAL COUNSELOR ASS)
(701) 430-2121
Entity
Organization
Contact information
Practice address
306 W MAIN ST, FRANKFORT, KY 40601-1895
(855) 591-0092
Mailing address
153 PENMOKEN PARK, LEXINGTON, KY 40503-1917
(701) 430-2121
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
170684
KY
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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