Healthcare Provider Details

I. General information

NPI: 1700799590
Provider Name (Legal Business Name): WESTERN KENTUCKY COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 SUNSET DR
LEITCHFIELD KY
42754-1829
US

IV. Provider business mailing address

210 SUNSET DR
LEITCHFIELD KY
42754-1829
US

V. Phone/Fax

Practice location:
  • Phone: 270-899-0939
  • Fax:
Mailing address:
  • Phone: 270-899-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SMITH
Title or Position: OWNER
Credential:
Phone: 270-899-0939