Organization
RIDGE OUTPATIENT COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI W HANCOCK (BUSINESS OFFICE MANAGER)
(859) 268-6455
Entity
Organization
Contact information
Practice address
3050 RIO DOSA DR, LEXINGTON, KY 40509-1540
(859) 269-2325
(859) 268-6472
Mailing address
3050 RIO DOSA DR, LEXINGTON, KY 40509-1540
(859) 269-2325
(859) 268-6472
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
273R00000X
Psychiatric Hospital Unit
Primary
100534
KY
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65937526
—
KY
05
—
7100247070
—
KY
Enumeration date
05/15/2007
Last updated
02/12/2015
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