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General NPI Number Information
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NPI Number | 1427866094
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Entity Type | Organization
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Legal Business Name | WELL PSYCHOTHERAPY
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 237 2ND ST STE 201
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City | PIKEVILLE
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State | KY
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Zip | 41501-4094
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Country | US
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Telephone | 859-414-6088
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Fax | 606-727-9566
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Provider Business Mailing Address
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Address Line | 237 2ND ST STE 201
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City | PIKEVILLE
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State | KY
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Zip | 41501-4094
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Country | US
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Telephone | 859-414-6088
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Fax | 606-727-9566
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Authorized Official
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Title or Position | OWNER
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Name | MARK HATFIELD
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Credential | LPCC
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Telephone | 859-414-6088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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