Healthcare Provider Details

I. General information

NPI: 1801138185
Provider Name (Legal Business Name): REBECCA J BAUGH LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CUNNINGHAM WAY
DANVILLE KY
40422-8339
US

IV. Provider business mailing address

400 CUNNINGHAM WAY
DANVILLE KY
40422-8339
US

V. Phone/Fax

Practice location:
  • Phone: 859-936-9482
  • Fax: 502-538-1112
Mailing address:
  • Phone: 859-936-9482
  • Fax: 502-538-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0872
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103851
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: