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General NPI Number Information
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NPI Number | 1508100447
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Entity Type | Organization
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Legal Business Name | TWIN LAKES COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 346 S MAIN ST
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City | LEITCHFIELD
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State | KY
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Zip | 42754-1428
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Country | US
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Telephone | 270-230-1777
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Fax | 270-679-0838
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Provider Business Mailing Address
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Address Line | PO BOX 4237
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City | LEITCHFIELD
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State | KY
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Zip | 42755-4237
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Country | US
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Telephone | 270-230-1777
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Fax | 270-679-0838
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | LUKE H HATFIELD I
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Credential | M.ED., LPCC, NCC
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Telephone | 270-230-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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