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General NPI Number Information
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NPI Number | 1558750406
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Entity Type | Organization
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Legal Business Name | APPALACHIAN COMMUNITY CARE LLC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 255 CHURCH ST STE 101
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City | PIKEVILLE
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State | KY
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Zip | 41501-3476
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Country | US
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Telephone | 606-432-5660
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Fax |
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Provider Business Mailing Address
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Address Line | 7145 E VIRGINIA ST STE 2000
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City | EVANSVILLE
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State | IN
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Zip | 47715-9147
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Country | US
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Telephone | 812-962-7894
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Fax | 812-476-6162
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOVONNE F RICHARDSON
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Credential | LPCC
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Telephone | 606-253-3045
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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 | 1520
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License Number State | KY
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