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General NPI Number Information
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NPI Number | 1609575992
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Entity Type | Individual
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Provider Name | CARINA JADE ATCHLEY LPCC
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 547 FLUSHING MEADOWS DR
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City | RINEYVILLE
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State | KY
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Zip | 40162-9446
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Country | US
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Telephone | 361-850-0662
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Fax |
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Provider Business Mailing Address
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Address Line | 547 FLUSHING MEADOWS DR
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City | RINEYVILLE
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State | KY
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Zip | 40162-9446
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Country | US
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Telephone | 361-850-0662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 275904
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License Number State | KY
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