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General NPI Number Information
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NPI Number | 1366907107
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Entity Type | Organization
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Legal Business Name | COGNITIVE THERAPY MINDFULNESS CENTER
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Dates
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Enumeration Date | 02/06/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 118 OLD LAFAYETTE AVE
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City | LEXINGTON
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State | KY
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Zip | 40502-1998
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Country | US
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Telephone | 859-687-7007
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Fax | 859-687-7007
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Provider Business Mailing Address
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Address Line | 118 OLD LAFAYETTE AVE
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City | LEXINGTON
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State | KY
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Zip | 40502-1998
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Country | US
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Telephone | 859-687-7007
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Fax | 859-687-7007
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | BARBARA GRAF
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Credential | LPCC
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Telephone | 859-687-7007
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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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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