Healthcare Provider Details

I. General information

NPI: 1558229542
Provider Name (Legal Business Name): GUIDED PATHWAYS OF KENTUCKY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 TWINBROOK LN UNIT 2
CORBIN KY
40701-2802
US

IV. Provider business mailing address

170 TWINBROOK LN UNIT 2
CORBIN KY
40701-2802
US

V. Phone/Fax

Practice location:
  • Phone: 606-304-1401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: BRENDA BRISON
Title or Position: TARGETED CASE MANAGER
Credential: TCM
Phone: 606-515-2855