Guided Healing Llc | |
1150 Paynes Depot Rd Georgetown KY 40324-9137 | |
(859) 940-0375 | |
(502) 305-2114 |
Full Name | Guided Healing Llc |
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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 |
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Provider Enumeration Date | 05/11/2023 |
Last Update Date | 05/11/2023 |
Certification Date | 05/11/2023 |
Medicare PECOS PAC ID | 1658714696 |
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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 |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1134819246 PECOS PAC ID: 2062863988 Enrollment ID: I20240207002977 |
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