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General NPI Number Information
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NPI Number | 1144601238
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Entity Type | Organization
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Legal Business Name | ABOUNDING LIFE COUNSELING AND SUPPORT, LLC
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 265 FERNWOOD DR
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City | WILLIAMSTOWN
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State | KY
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Zip | 41097-4203
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Country | US
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Telephone | 859-391-6046
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Fax |
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Provider Business Mailing Address
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Address Line | 265 FERNWOOD DR
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City | WILLIAMSTOWN
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State | KY
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Zip | 41097-4203
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Country | US
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Telephone | 859-391-6046
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH NURSE PRACTIONER
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Name | MS. PHYLLIS B. REED
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Credential | PMH-APRN-BC
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Telephone | 859-391-6046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3005009
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License Number State | KY
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