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General NPI Number Information
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NPI Number | 1619631926
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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 | 10/25/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 100 PROFESSIONAL LN, STE 201
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City | HARLAN
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State | KY
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Zip | 40831-2590
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Country | US
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Telephone | 606-633-4979
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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 | 812-962-7890
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LOVONNE FLEMING-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 |
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License Number State |
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