| Cardinal Behavioral Health Pllc | |
|
719 Dishman Lane Ext Apt C Bowling Green KY 42104-4072 | |
| (270) 202-8669 | |
| (270) 200-8781 |
| Full Name | Cardinal Behavioral Health Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 719 Dishman Lane Ext Apt C, Bowling Green, Kentucky |
| Authorized Official Name and Position | Joellen Marion (PRESIDENT) |
| Authorized Official Contact | 2702028669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardinal Behavioral Health Pllc 719 Dishman Lane Ext Apt C Bowling Green KY 42104-4072 Ph: (270) 202-8669 | Cardinal Behavioral Health Pllc 719 Dishman Lane Ext Apt C Bowling Green KY 42104-4072 Ph: (270) 202-8669 |
| NPI Number | 1366112823 |
|---|---|
| Provider Enumeration Date | 09/16/2021 |
| Last Update Date | 11/15/2024 |
| Certification Date | 11/08/2024 |
| Medicare PECOS PAC ID | 3375988306 |
|---|---|
| Medicare Enrollment ID | O20240229003629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366112823 | NPI | - | NPPES |
| 7100886940 | Medicaid | KY |
| Provider Name | Joellen Marie Marion |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346632007 PECOS PAC ID: 6002251030 Enrollment ID: I20240305000305 |
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