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600 Rodeo Dr Fl 2 Erlanger KY 41018-1279 | |
| (859) 282-0204 | |
| (859) 282-0361 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 600 Rodeo Dr Fl 2, Erlanger, Kentucky |
| Authorized Official Name and Position | Shari A Franco-fisher (CEO, MANAGING MEMBER) |
| Authorized Official Contact | 8592820204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
600 Rodeo Dr Fl 2 Erlanger KY 41018-1279 Ph: (859) 282-0204 | 600 Rodeo Dr Fl 2 Erlanger KY 41018-1279 Ph: (859) 282-0204 |
| NPI Number | 1063975100 |
|---|---|
| Provider Enumeration Date | 04/06/2019 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 2163966227 |
|---|---|
| Medicare Enrollment ID | O20240628003706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063975100 | NPI | - | NPPES |
| 7100404120 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shari Anne Francofisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235366006 PECOS PAC ID: 0042500654 Enrollment ID: I20240628003765 |
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