Healthcare Provider Details

I. General information

NPI: 1548745425
Provider Name (Legal Business Name): COUNSELING ASSOCIATES OF OWENSBORO, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 FREDERICA ST
OWENSBORO KY
42301-4801
US

IV. Provider business mailing address

1316 FREDERICA ST
OWENSBORO KY
42301-4801
US

V. Phone/Fax

Practice location:
  • Phone: 270-686-7999
  • Fax: 270-686-8092
Mailing address:
  • Phone: 270-686-7999
  • Fax: 270-686-8092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANGELA BELL
Title or Position: THERAPIST
Credential: LCSW
Phone: 270-686-7999