Organization
THERAPEUTIC VILLLAGE, LLC
Active
Other names
Therapeutic Village
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL LYNN ELAM LMFT (OWNER)
(859) 595-5860
Entity
Organization
Contact information
Practice address
19 WAINSCOTT AVE, WINCHESTER, KY 40391-1970
(859) 595-5860
(502) 808-6041
Mailing address
5580 ECTON RD, WINCHESTER, KY 40391-9626
(859) 595-5860
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/19/2015
Last updated
04/14/2016
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