Healthcare Provider Details

I. General information

NPI: 1528784592
Provider Name (Legal Business Name): PEACE OF MIND COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 LEXINGTON RD
RICHMOND KY
40475-1060
US

IV. Provider business mailing address

1503 LEXINGTON RD
RICHMOND KY
40475-1060
US

V. Phone/Fax

Practice location:
  • Phone: 859-353-8568
  • Fax: 844-379-6646
Mailing address:
  • Phone: 859-353-8568
  • Fax: 844-379-6646

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 Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. AIMEE E KIDD
Title or Position: OWNER, LPCC
Credential: LPCC
Phone: 859-582-2512