Healthcare Provider Details

I. General information

NPI: 1982521373
Provider Name (Legal Business Name): NATASHA ROLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATASHA HART

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S LAUREL RD
LONDON KY
40744-8016
US

IV. Provider business mailing address

125 S LAUREL RD
LONDON KY
40744-8016
US

V. Phone/Fax

Practice location:
  • Phone: 606-770-5086
  • Fax: 863-456-1301
Mailing address:
  • Phone: 606-770-5086
  • Fax: 863-456-1301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: