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General NPI Number Information
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NPI Number | 1477135655
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Entity Type | Organization
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Legal Business Name | GREATER OWENSBORO COUNSELING PARTNERS INC
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 4531 HWY 54 STE 1
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City | OWENSBORO
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State | KY
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Zip | 42303-2486
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Country | US
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Telephone | 270-240-4425
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Fax | 270-228-4252
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Provider Business Mailing Address
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Address Line | 4531 HWY 54 STE 1
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City | OWENSBORO
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State | KY
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Zip | 42303-2486
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Country | US
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Telephone | 270-240-4425
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Fax | 270-228-4252
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | JAMIE FORTHMAN
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Credential |
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Telephone | 270-557-6396
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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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