MEDICARE: ABUNDANTLY WELL COUNSELING LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	1041C0700X	Clinical Social Worker
3	101YP2500X	Professional Counselor
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1922946235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANTLY WELL COUNSELING LLC

Provider Business Mailing Address
First Line	:	101 N MAIN ST
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-3101
Country	:	US
Telephone Number	:	270-302-7870
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N MAIN ST
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-3101
Country	:	US
Telephone Number	:	270-302-7870
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	JAMA PHILLIPS
Credential	:	LLC
Telephone Number	:	270-302-7870

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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