Healthcare Provider Details

I. General information

NPI: 1861530610
Provider Name (Legal Business Name): COUNSELING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 FREDERICA STREET
OWENSBORO KY
42301
US

IV. Provider business mailing address

1316 FREDERICA STREET
OWENSBORO KY
42301
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 TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. TRACY MCGARY
Title or Position: OFFICE MANAGER
Credential:
Phone: 270-686-7999