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NPI Code Detail

MEDICARE: MORGAN FAYTH BASHAM

MEDICARE: MORGAN FAYTH BASHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1053116640
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN FAYTH BASHAM
Provider Business Mailing Address
First Line : 1106 TUNNEL HILL RD STE 100
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-8026
Country : US
Telephone Number : 270-765-2335
Fax Number :
Provider Business Practice Location Address
First Line : 1106 TUNNEL HILL RD STE 100
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-8026
Country : US
Telephone Number : 270-765-2335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2025
Last Update Date : 02/17/2025

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Directions to “ MORGAN FAYTH BASHAM ” Practice Location

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