Organization
KENTUCKY COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLEE PHELPS (VICE PRESIDENT OF HUMAN RESOURCES)
(859) 625-4663
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY STE 3328, LOUISVILLE, KY 40217-1415
(855) 591-0092
(502) 631-9660
Mailing address
PO BOX 701059, PMB 50499, LOUISVILLE, KY 40270
(855) 591-0092
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
216680
KY
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
216680
KY
363L00000X
Nurse Practitioner
216680
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100343850
—
KY
Enumeration date
02/07/2015
Last updated
08/26/2022
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