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General NPI Number Information
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NPI Number | 1295400083
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Entity Type | Organization
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Legal Business Name | AEGIS MENTAL HEALTH
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 671 W HWY 80 STE 1
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City | SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-425-4567
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Fax | 606-425-5134
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Provider Business Mailing Address
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Address Line | 671 W HWY 80 STE 1
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City | SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-425-4567
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Fax | 606-425-5134
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Authorized Official
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Title or Position | PARTNER
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Name | SAMANTHA WILSON
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Credential | LPCC
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Telephone | 859-358-6568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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