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General NPI Number Information
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NPI Number | 1013344084
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Entity Type | Organization
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Legal Business Name | RESTORATION COUNSELING
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 1830 DESTINY LN
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City | BOWLING GREEN
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State | KY
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Zip | 42104-1087
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Country | US
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Telephone | 270-846-3222
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Fax | 270-846-3228
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Provider Business Mailing Address
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Address Line | 1830 DESTINY LN
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City | BOWLING GREEN
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State | KY
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Zip | 42104-1087
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Country | US
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Telephone | 270-846-3222
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Fax | 270-846-3228
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MRS. LISA R RICE
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Credential | MAE, LMFT
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Telephone | 270-846-3222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0756
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License Number State | KY
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