=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871009373
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENCOURAGING HEARTS COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2017
-----------------------------------------------------
Last Update Date | 03/03/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 921 N MAIN ST
-----------------------------------------------------
City | ELIZABETHTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42701-1256
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-300-3229
-----------------------------------------------------
Fax | 270-209-0798
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 921 N MAIN ST
-----------------------------------------------------
City | ELIZABETHTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42701-1256
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-300-3229
-----------------------------------------------------
Fax | 270-209-0798
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANGELA ELIZABETH HUBLICK
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 270-300-3229
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 3973
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------