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General NPI Number Information
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NPI Number | 1588237887
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Entity Type | Organization
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Legal Business Name | MIND GROWING COUNSELING
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 511 BIG BEAR LN
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City | LEXINGTON
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State | KY
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Zip | 40517-2053
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Country | US
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Telephone | 859-287-4125
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55545
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City | LEXINGTON
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State | KY
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Zip | 40555-5545
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUDREY LINVILLE
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Credential | LCSW
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Telephone | 859-287-4125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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