Healthcare Provider Details

I. General information

NPI: 1639560014
Provider Name (Legal Business Name): HOPE SPRINGS COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 DOVE RUN RD STE 202
LEXINGTON KY
40502-3500
US

IV. Provider business mailing address

1081 DOVE RUN RD STE 202
LEXINGTON KY
40502-3500
US

V. Phone/Fax

Practice location:
  • Phone: 859-242-5201
  • Fax: 859-317-9437
Mailing address:
  • Phone: 859-242-5201
  • Fax: 859-317-9437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0436
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0769
License Number StateKY

VIII. Authorized Official

Name: WANDA DAY
Title or Position: COUNSELOR
Credential: LPCC
Phone: 859-242-5201