Organization
COLLABORATIVE COUNSELING GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS K LONNEMAN LPCC (CEO)
(270) 234-0267
Entity
Organization
Contact information
Practice address
208 N MULBERRY ST, ELIZABETHTOWN, KY 42701-1464
(270) 312-2860
(270) 312-2860
Mailing address
202 N MULBERRY ST, ELIZABETHTOWN, KY 42701-1441
(270) 312-2860
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/06/2017
Last updated
01/24/2018
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