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General NPI Number Information
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NPI Number | 1457238610
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Entity Type | Organization
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Legal Business Name | KENTUCKIANA TREATMENT CENTER FOR ANXIETY & OCD LLC
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 100 W 3RD ST STE 304
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City | OWENSBORO
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State | KY
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Zip | 42303-4129
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Country | US
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Telephone | 270-238-3566
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Fax |
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Provider Business Mailing Address
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Address Line | 100 W 3RD ST STE 304
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City | OWENSBORO
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State | KY
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Zip | 42303-4129
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Country | US
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Telephone | 270-238-3566
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY ELIZABETH LEINS
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Credential | PSYD
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Telephone | 502-341-4742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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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 | 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 #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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