Organization
31:2 COUNSELING GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES LEWIS LCSW (THERAPIST/OWNER)
(270) 807-0533
Entity
Organization
Contact information
Practice address
111 N WOODLAND DR STE B, RADCLIFF, KY 40160-2678
(270) 348-4840
Mailing address
127 MEDICAL CENTER DR, RADCLIFF, KY 40160-8959
(270) 348-4840
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100560030
—
KY
Enumeration date
05/05/2019
Last updated
05/28/2021
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