| Guided Healing Llc | |
|
1150 Paynes Depot Rd Georgetown KY 40324-9137 | |
| (859) 940-0375 | |
| (502) 305-2114 |
| Full Name | Guided Healing Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1150 Paynes Depot Rd, Georgetown, Kentucky |
| Authorized Official Name and Position | Sara E Staker (OWNER) |
| Authorized Official Contact | 8599400375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guided Healing Llc 101 N Bradford Ln Unit 1195 Georgetown KY 40324-0318 Ph: (859) 940-0375 | Guided Healing Llc 1150 Paynes Depot Rd Georgetown KY 40324-9137 Ph: (859) 940-0375 |
| NPI Number | 1033809157 |
|---|---|
| Provider Enumeration Date | 05/11/2023 |
| Last Update Date | 05/11/2023 |
| Certification Date | 05/11/2023 |
| Medicare PECOS PAC ID | 1658714696 |
|---|---|
| Medicare Enrollment ID | O20240207001450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033809157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Sara E Staker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134819246 PECOS PAC ID: 2062863988 Enrollment ID: I20240207002977 |
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