| Courage To Change Counseling Services Llc | |
|
311 Walker Ln London KY 40744-9036 | |
| (606) 224-8451 | |
| Not Available |
| Full Name | Courage To Change Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 311 Walker Ln, London, Kentucky |
| Authorized Official Name and Position | David T Tipton (OWNER) |
| Authorized Official Contact | 6062248451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Courage To Change Counseling Services Llc 311 Walker Ln London KY 40744-9036 Ph: (606) 224-8451 | Courage To Change Counseling Services Llc 311 Walker Ln London KY 40744-9036 Ph: (606) 224-8451 |
| NPI Number | 1912761933 |
|---|---|
| Provider Enumeration Date | 02/09/2024 |
| Last Update Date | 09/27/2024 |
| Certification Date | 09/27/2024 |
| Medicare PECOS PAC ID | 0345689659 |
|---|---|
| Medicare Enrollment ID | O20240419001303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912761933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | David Terry Tipton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376312397 PECOS PAC ID: 1254770563 Enrollment ID: I20240422000119 |
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