Organization
GREEN MEADOWS WELLNESS CENTER ONE, LLC
Active
Organization
GREEN MEADOWS WELLNESS CENTER ONE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY FITCH (BUSINESS MANAGER)
(606) 309-1291
Entity
Organization
Contact information
Practice address
8554 KY 1232, CORBIN, KY 40701-6417
(606) 261-7622
(606) 261-7312
Mailing address
8554 KY 1232, CORBIN, KY 40701-6417
(606) 261-7622
(606) 261-7312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TS0200X
School Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720730021
—
KY
05
—
7100360730
—
KY
05
—
7100406190
—
KY
05
—
7100606760
—
KY
Enumeration date
12/17/2018
Last updated
09/08/2022
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