Healthcare Provider Details

I. General information

NPI: 1801344635
Provider Name (Legal Business Name): DANVILLE COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 S 2ND ST
DANVILLE KY
40422-1804
US

IV. Provider business mailing address

204 S 2ND ST
DANVILLE KY
40422-1804
US

V. Phone/Fax

Practice location:
  • Phone: 859-374-0238
  • Fax:
Mailing address:
  • Phone: 859-374-0238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number103851
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JESSICA WIGGINTON
Title or Position: OWNER
Credential: LCSW
Phone: 859-374-0238