Healthcare Provider Details

I. General information

NPI: 1003512674
Provider Name (Legal Business Name): HEALING PATH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 ASHLEY CIR STE 1
BOWLING GREEN KY
42104-5803
US

IV. Provider business mailing address

1228 ASHLEY CIR STE 1
BOWLING GREEN KY
42104-5803
US

V. Phone/Fax

Practice location:
  • Phone: 270-202-1096
  • Fax: 270-495-1906
Mailing address:
  • Phone: 270-202-1096
  • Fax: 270-495-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PAIGE FLORA
Title or Position: THERAPIST
Credential: LPCC
Phone: 270-202-1096