Organization
COUNSELOR'S CLINICAL COTTAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADE A MADDOX LPCC (OWNER)
(606) 329-0727
Entity
Organization
Contact information
Practice address
2740 WINCHESTER AVE, ASHLAND, KY 41101-1929
(606) 329-0727
Mailing address
2740 WINCHESTER AVE, ASHLAND, KY 41101-1929
(606) 329-0727
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0666
KY
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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