Organization
ASPIRE BEHAVIORAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RUSSELL LPCC (THERAPIST)
(270) 228-2414
Entity
Organization
Contact information
Practice address
343 S MAIN ST, BEAVER DAM, KY 42320
(270) 228-2414
Mailing address
PO BOX 292, BEAVER DAM, KY 42320-0292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
163595
KY
Other
Enumeration date
07/12/2016
Last updated
08/08/2018
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