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General NPI Number Information
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NPI Number | 1013649250
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Entity Type | Organization
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Legal Business Name | WINDS OF CHANGE LLC
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 1220 MASTER ST STE 6
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City | CORBIN
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State | KY
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Zip | 40701-2517
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Country | US
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Telephone | 606-404-5104
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Fax | 606-404-5105
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Provider Business Mailing Address
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Address Line | 1220 MASTER ST STE 6
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City | CORBIN
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State | KY
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Zip | 40701-2517
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Country | US
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Telephone | 606-404-5104
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Fax | 606-404-5105
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Authorized Official
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Title or Position | MEMBER
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Name | KIMBERLY HOPE HUDDLESTON
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Credential |
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Telephone | 606-404-5105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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