Healthcare Provider Details

I. General information

NPI: 1548185465
Provider Name (Legal Business Name): A MOUNTAIN OF HOPE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 PROSPEROUS PL STE 4A
LEXINGTON KY
40509-1828
US

IV. Provider business mailing address

121 PROSPEROUS PL STE 4A
LEXINGTON KY
40509-1828
US

V. Phone/Fax

Practice location:
  • Phone: 859-333-1009
  • Fax:
Mailing address:
  • Phone: 859-333-1009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CAROLYNN LEE
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 859-333-1009