Healthcare Provider Details
I. General information
NPI: 1689309635
Provider Name (Legal Business Name): K&G COUNSELING AND CONSULTING, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2530 SCOTTSVILLE ROAD 17
BOWLING GREEN KY
42104-4210
US
IV. Provider business mailing address
2530 SCOTTSVILLE ROAD 17
BOWLING GREEN KY
42104
US
V. Phone/Fax
- Phone: 270-598-2394
- Fax:
- Phone: 270-598-2394
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
LINDSEY
KATE
WHITLEY
Title or Position: CO-OWNER/THERAPIST
Credential: LPCC
Phone: 615-886-0159