MEDICARE: PAIN TO PURPOSE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1285424051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN TO PURPOSE LLC

Provider Business Mailing Address
First Line	:	3313 LEXINGTON RD
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-9524
Country	:	US
Telephone Number	:	859-953-1006
Fax Number	:	859-545-5294

Provider Business Practice Location Address
First Line	:	3313 LEXINGTON RD
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-9524
Country	:	US
Telephone Number	:	859-953-1006
Fax Number	:	859-545-5294

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	TAMMY LYNN GOLDY
Credential	:	APSS
Telephone Number	:	859-953-1006

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	05/07/2025

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Directions to “PAIN TO PURPOSE LLC ” Practice Location

Language	Start Address	Practice Location

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