Katrina Sheree Long, | |
2349 Russellville Rd, Bowling Green, KY 42101-3986 | |
(270) 282-8280 | |
Not Available |
Full Name | Katrina Sheree Long |
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Gender | Female |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 2349 Russellville Rd, Bowling Green, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1871288993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YA0400X | Counselor - Addiction (substance Use Disorder) | 281024 (Kentucky) | Primary |
Entity Name | Cleanslate Medical Group Of Kentucky Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538600630 PECOS PAC ID: 4486909769 Enrollment ID: O20180611002156 |
Mailing Address | Practice Location Address |
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Katrina Sheree Long, 2363 Foxridge Ct Apt 811, Bowling Green, KY 42101-4125 Ph: (270) 938-2762 | Katrina Sheree Long, 2349 Russellville Rd, Bowling Green, KY 42101-3986 Ph: (270) 282-8280 |
Mr. Gatt Read Ware Sr., TLCADC, BIP Counselor Medicare: Not Enrolled in Medicare Practice Location: 1043 Pedigo Way Ste 30, Bowling Green, KY 42103 Phone: 270-495-1224 Fax: 270-599-0023 | |
Heather Charlene Knight, Counselor Medicare: Not Enrolled in Medicare Practice Location: 380 Suwannee Trail St, Bowling Green, KY 42103 Phone: 270-901-5000 | |
Natalie Christine Kelley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1906 College Heights Blvd, Bowling Green, KY 42101 Phone: 270-745-4204 | |
Emily A Taylor, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1035 Porter Pike, Bowling Green, KY 42103 Phone: 270-418-6327 | |
Mrs. Rozalind Bell, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1711 Ashley Cir, Suite 2, Bowling Green, KY 42104 Phone: 270-935-5125 | |
Karen T Garrity, LPCC, LCADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 380 Suwannee Trail Street, Bowling Green, KY 42103 Phone: 270-901-5000 Fax: 270-842-5268 | |
Kylee Sipes, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1621 Scottsville Rd, Bowling Green, KY 42104 Phone: 270-746-6600 Fax: 270-842-9008 |