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General NPI Number Information
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NPI Number | 1295553816
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Entity Type | Organization
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Legal Business Name | NOURISH MENTAL HEALTH
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 7600 W HIGHWAY 146 STE 200
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City | PEWEE VALLEY
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State | KY
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Zip | 40056-8110
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Country | US
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Telephone | 502-805-9699
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Fax | 502-805-9664
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Provider Business Mailing Address
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Address Line | 3014 FAIRWAY DR
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City | FLOYDS KNOBS
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State | IN
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Zip | 47119-9615
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Country | US
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Telephone | 502-805-9699
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ADAM MITCHELL
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Credential | PMHNP
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Telephone | 615-598-7643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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