| Essential Healing Iop, Inc | |
|
1795 Alysheba Way 1001 Lexington KY 40509-2282 | |
| (859) 687-0416 | |
| (859) 353-4200 |
| Full Name | Essential Healing Iop, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1795 Alysheba Way, Lexington, Kentucky |
| Authorized Official Name and Position | Stevanie Smith (PROGRAM DIRECTOR/THERAPIST) |
| Authorized Official Contact | 8596870416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Healing Iop, Inc 1795 Alysheba Way 1001 Lexington KY 40509-2282 Ph: (859) 687-0416 | Essential Healing Iop, Inc 1795 Alysheba Way 1001 Lexington KY 40509-2282 Ph: (859) 687-0416 |
| NPI Number | 1417374943 |
|---|---|
| Provider Enumeration Date | 03/21/2014 |
| Last Update Date | 02/17/2017 |
| Medicare PECOS PAC ID | 6800122169 |
|---|---|
| Medicare Enrollment ID | O20190724000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417374943 | NPI | - | NPPES |
| 800171 | Other | KY | BHSO - BEHAVIORAL HEALTH SERVICES ORGANIZATION |
| 810448 | Other | KY | AODE - ALCOHOL AND OTHER DRUG ENTITY |
| 7100294500 | Medicaid | KY |
| Provider Name | Anthony Joseph Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508959495 PECOS PAC ID: 4789859364 Enrollment ID: I20111209000194 |
| Provider Name | Jessica M Marshal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447793872 PECOS PAC ID: 9830471317 Enrollment ID: I20170117002576 |
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