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NPI Code Detail

MEDICARE: COREY BIRCH LPCC

MEDICARE: COREY BIRCH LPCC
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 CounselorC.1400325OH

General Provider Information

NPI Number : 1245613744
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY BIRCH LPCC
Provider Business Mailing Address
First Line : 503 DARBY CREEK RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-1603
Country : US
Telephone Number : 859-264-8797
Fax Number : 859-264-9957
Provider Business Practice Location Address
First Line : 503 DARBY CREEK RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-1603
Country : US
Telephone Number : 859-264-8797
Fax Number : 859-264-9957
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2015
Last Update Date : 10/23/2015

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Directions to “ COREY BIRCH LPCC” Practice Location

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