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General NPI Number Information
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NPI Number | 1407454127
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Entity Type | Organization
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Legal Business Name | EK WELLNESS GROUP LLC
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 412 ROY CAMPBELL DR
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City | HAZARD
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State | KY
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Zip | 41701-9453
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Country | US
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Telephone | 606-216-7833
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Fax |
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Provider Business Mailing Address
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Address Line | 412 ROY CAMPBELL DR
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City | HAZARD
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State | KY
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Zip | 41701-9453
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Country | US
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Telephone | 606-216-7833
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MS. LUCY MICHELLE LANGDON
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Credential | M.ED. LPCA
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Telephone | 606-216-7833
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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 | 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 #3
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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 #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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