Healthcare Provider Details

I. General information

NPI: 1184016123
Provider Name (Legal Business Name): BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2015
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 PARK ST 204
BOWLING GREEN KY
42101-1784
US

IV. Provider business mailing address

PO BOX 117924
ATLANTA GA
30368-7924
US

V. Phone/Fax

Practice location:
  • Phone: 270-843-5103
  • Fax: 270-843-5104
Mailing address:
  • Phone: 270-843-5103
  • Fax: 270-843-5104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: MICHELE LAWLESS
Title or Position: EXECUTIVE VICE PRESIDENT / CFO
Credential:
Phone: 270-745-1500