MEDICARE: WELL PLANTED COUNSELING SERVICES, INC.

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1528687753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL PLANTED COUNSELING SERVICES, INC.

Provider Business Mailing Address
First Line	:	1039 E KENTUCKY ST
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1935
Country	:	US
Telephone Number	:	502-418-8247
Fax Number	:

Provider Business Practice Location Address
First Line	:	1979 RICHMOND DR STE 2
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-1411
Country	:	US
Telephone Number	:	502-418-8247
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALEVE DOUGLAS
Credential	:	LPCC
Telephone Number	:	502-418-8247

Provider Enumeration Date	:	04/08/2020
Last Update Date	:	04/08/2020

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