Healthcare Provider Details

I. General information

NPI: 1114439981
Provider Name (Legal Business Name): JANIE PING DBA RENEWED HOPE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 JACKSBORO ST
FERGUSON KY
42533-9556
US

IV. Provider business mailing address

703 JACKSBORO ST
FERGUSON KY
42533-9556
US

V. Phone/Fax

Practice location:
  • Phone: 606-219-0614
  • Fax: 606-485-4193
Mailing address:
  • Phone: 606-219-0614
  • Fax: 606-485-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number103522
License Number StateKY

VIII. Authorized Official

Name: JANIE PING
Title or Position: COUNSELOR
Credential: LPCC
Phone: 606-216-0614