Healthcare Provider Details

I. General information

NPI: 1750126041
Provider Name (Legal Business Name): ALI COUNSELING GROUP SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W DIXIE AVE STE 4
ELIZABETHTOWN KY
42701-1575
US

IV. Provider business mailing address

653 WINDBROOK DR
ELIZABETHTOWN KY
42701-6827
US

V. Phone/Fax

Practice location:
  • Phone: 502-994-0901
  • Fax:
Mailing address:
  • Phone: 502-500-4452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: SHAMEKA TAWANN SELLS-MOORE
Title or Position: OWNER/COUNSELOR
Credential: LPCC
Phone: 502-500-4452