Healthcare Provider Details

I. General information

NPI: 1174702252
Provider Name (Legal Business Name): GINGER VANMETER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINGER SANDERS

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1143 FAIRWAY ST SUITE 103
BOWLING GREEN KY
42103
US

IV. Provider business mailing address

1143 FAIRWAY ST SUITE 103
BOWLING GREEN KY
42103
US

V. Phone/Fax

Practice location:
  • Phone: 270-393-9833
  • Fax: 270-393-9835
Mailing address:
  • Phone: 270-393-9833
  • Fax: 270-393-9835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3838
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: