Birchwood Healing Place | |
1050 Chinoe Rd Ste 112 Lexington KY 40502-6571 | |
(859) 312-6569 | |
(855) 594-5062 |
Full Name | Birchwood Healing Place |
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Speciality | Social Worker - Clinical |
Location | 1050 Chinoe Rd Ste 112, Lexington, Kentucky |
Authorized Official Name and Position | Loretta Lynn Gilmore (LICENSED CLINICAL SOCIAL WORK / OWN) |
Authorized Official Contact | 8593126569 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Birchwood Healing Place 1050 Chinoe Rd Ste 112 Lexington KY 40502-6571 Ph: (859) 312-6569 | Birchwood Healing Place 1050 Chinoe Rd Ste 112 Lexington KY 40502-6571 Ph: (859) 312-6569 |
NPI Number | 1033684477 |
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Provider Enumeration Date | 10/12/2018 |
Last Update Date | 10/16/2024 |
Certification Date | 10/16/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033684477 | NPI | - | NPPES |
7100422750 | Medicaid | KY | |
7100958780 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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