Healthcare Provider Details

I. General information

NPI: 1013788009
Provider Name (Legal Business Name): JENNIFER EICH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N BROADWAY ST STE 1
BEREA KY
40403-2212
US

IV. Provider business mailing address

344 KEITH DR
BEREA KY
40403-8892
US

V. Phone/Fax

Practice location:
  • Phone: 859-248-4101
  • Fax: 877-583-4715
Mailing address:
  • Phone: 859-248-4101
  • Fax: 877-583-4715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER EICH
Title or Position: OWNER/COUNSELOR
Credential: LPCC
Phone: 859-248-4101