Healthcare Provider Details

I. General information

NPI: 1528342755
Provider Name (Legal Business Name): IVORY HOWELL COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W 3RD ST STE 304
OWENSBORO KY
42303-4129
US

IV. Provider business mailing address

100 W 3RD ST STE 304
OWENSBORO KY
42303-4129
US

V. Phone/Fax

Practice location:
  • Phone: 270-698-9777
  • Fax: 270-698-9778
Mailing address:
  • Phone: 270-698-9777
  • Fax: 270-698-9778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1057
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: IVORY SHAE HOWELL
Title or Position: OWNER
Credential: LPCC
Phone: 270-302-1669