| Lifeskills, Inc. | |
|
380 Suwannee Trail St Bowling Green KY 42103-7956 | |
| (270) 901-5000 | |
| (270) 842-5268 |
| Full Name | Lifeskills, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 380 Suwannee Trail St, Bowling Green, Kentucky |
| Authorized Official Name and Position | Joe Dan Beavers (CEO) |
| Authorized Official Contact | 2709015000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeskills, Inc. 380 Suwannee Trail St Bowling Green KY 42103-7956 Ph: (270) 901-5000 | Lifeskills, Inc. 380 Suwannee Trail St Bowling Green KY 42103-7956 Ph: (270) 901-5000 |
| NPI Number | 1669401816 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Medicare PECOS PAC ID | 8820902638 |
|---|---|
| Medicare Enrollment ID | O20031117000330 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669401816 | NPI | - | NPPES |
| 30604011 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
| Provider Name | Glenna E Major |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225083108 PECOS PAC ID: 6204866569 Enrollment ID: I20050816000885 |
| Provider Name | Llewelyn N Hortillosa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104876192 PECOS PAC ID: 0749208890 Enrollment ID: I20051107000868 |
| Provider Name | Jeffrey L Zellers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689787558 PECOS PAC ID: 5294837233 Enrollment ID: I20070222000449 |
| Provider Name | Katrena L Blackwell |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1205918224 PECOS PAC ID: 7810096443 Enrollment ID: I20070706000344 |
| Provider Name | Laura A Gaines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306987847 PECOS PAC ID: 8921197377 Enrollment ID: I20071207000569 |
| Provider Name | Steven L Thore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013113745 PECOS PAC ID: 7113002148 Enrollment ID: I20080314000130 |
| Provider Name | Carol Stowe-byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649436619 PECOS PAC ID: 2163580226 Enrollment ID: I20081020000141 |
| Provider Name | Donald H Goble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659454569 PECOS PAC ID: 8820281736 Enrollment ID: I20101025000303 |
| Provider Name | Randy A Hultberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104846575 PECOS PAC ID: 3476618323 Enrollment ID: I20101123000787 |
| Provider Name | Regina E Robison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316269871 PECOS PAC ID: 4880726231 Enrollment ID: I20101216000615 |
| Provider Name | Lee A. Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700191228 PECOS PAC ID: 0648488015 Enrollment ID: I20110331000358 |
| Provider Name | Billie J Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114234739 PECOS PAC ID: 3779751557 Enrollment ID: I20110721000621 |
| Provider Name | Lorri L Houck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386931715 PECOS PAC ID: 1759553548 Enrollment ID: I20111228000692 |
| Provider Name | Audra Scott Harrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285717470 PECOS PAC ID: 4688838592 Enrollment ID: I20120605000562 |
| Provider Name | Christopher B Stepp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295026193 PECOS PAC ID: 7416265392 Enrollment ID: I20150925000634 |
| Provider Name | Tisha Nerene Blakeley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295157238 PECOS PAC ID: 5799095873 Enrollment ID: I20151102000331 |
| Provider Name | Cindy Petzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669785242 PECOS PAC ID: 6800103326 Enrollment ID: I20160519000627 |
| Provider Name | Jenna Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255740338 PECOS PAC ID: 9537439179 Enrollment ID: I20170717003233 |
| Provider Name | Kerry Bordieri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073035291 PECOS PAC ID: 9032489844 Enrollment ID: I20170726002239 |
| Provider Name | Rachel Eliazbeth Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104348358 PECOS PAC ID: 3476824731 Enrollment ID: I20170803003906 |
| Provider Name | Tiffany Heckel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609200641 PECOS PAC ID: 7315219052 Enrollment ID: I20170816000255 |
| Provider Name | Kayla Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881103448 PECOS PAC ID: 0941561641 Enrollment ID: I20180220002339 |
| Provider Name | Sherry Susan Cruise |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396115515 PECOS PAC ID: 0345595476 Enrollment ID: I20180613003260 |
| Provider Name | Michael A Daniel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336670835 PECOS PAC ID: 7618212101 Enrollment ID: I20190103001058 |
| Provider Name | Chelsey Dawn Reeves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043765811 PECOS PAC ID: 3870832140 Enrollment ID: I20190304002012 |
| Provider Name | Shelbie Rae Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265809917 PECOS PAC ID: 6305173618 Enrollment ID: I20190808004220 |
| Provider Name | Jennifer R. Koranyi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780126532 PECOS PAC ID: 6406183680 Enrollment ID: I20190809003068 |
| Provider Name | Lauren Paige Ollery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003338120 PECOS PAC ID: 9234565672 Enrollment ID: I20200204000924 |
| Provider Name | Akiloh Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518318583 PECOS PAC ID: 0042639569 Enrollment ID: I20201002001442 |
| Provider Name | Kaitlin Loveless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417564485 PECOS PAC ID: 9537579263 Enrollment ID: I20201106002002 |
| Provider Name | Allison Ann Bivins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912497132 PECOS PAC ID: 1254744022 Enrollment ID: I20210115001963 |
| Provider Name | Melody Marie Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285170605 PECOS PAC ID: 3072929231 Enrollment ID: I20210312001166 |
| Provider Name | Jeremy Daniel Seffens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134697022 PECOS PAC ID: 8729487400 Enrollment ID: I20210528002441 |
| Provider Name | Ollie Louise Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285018440 PECOS PAC ID: 2668879255 Enrollment ID: I20210923003787 |
| Provider Name | Holly Michelle Perez-knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649730318 PECOS PAC ID: 7214335785 Enrollment ID: I20211013003118 |
| Provider Name | Billie Jo Pedigo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801332218 PECOS PAC ID: 5991199499 Enrollment ID: I20220228000137 |
| Provider Name | Londa Michelle Stockton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043866239 PECOS PAC ID: 9133515026 Enrollment ID: I20220331003048 |
| Provider Name | Courtney Za'nea Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235607185 PECOS PAC ID: 3577945013 Enrollment ID: I20220801001628 |
| Provider Name | Amber Nechole Hackney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043626039 PECOS PAC ID: 8628450947 Enrollment ID: I20220803002743 |
| Provider Name | Breanne Nicolle Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841816428 PECOS PAC ID: 9739556713 Enrollment ID: I20221103001886 |
| Provider Name | Shaye Watts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316619711 PECOS PAC ID: 6204206410 Enrollment ID: I20230104003038 |
| Provider Name | Angela Lasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588380349 PECOS PAC ID: 3779573191 Enrollment ID: I20230111001008 |
| Provider Name | Brett Anthony Bond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194425033 PECOS PAC ID: 1759755101 Enrollment ID: I20230327000166 |
| Provider Name | Mary Elizabeth Langford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891310900 PECOS PAC ID: 8527421668 Enrollment ID: I20230823000524 |
| Provider Name | Brittney Taylor Helms Mckendrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174141840 PECOS PAC ID: 9133573678 Enrollment ID: I20231002002777 |
| Provider Name | Laura Black |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043695927 PECOS PAC ID: 3971952789 Enrollment ID: I20231205002952 |
| Provider Name | Laura Kimbel Bush |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457627473 PECOS PAC ID: 5890144273 Enrollment ID: I20231211001690 |
| Provider Name | Seth Brian Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487212353 PECOS PAC ID: 7618327784 Enrollment ID: I20240102002653 |
| Provider Name | Zane Boyd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366823643 PECOS PAC ID: 0648620740 Enrollment ID: I20240102003664 |
| Provider Name | Mark James Saderholm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265567549 PECOS PAC ID: 0941650949 Enrollment ID: I20240102003964 |
| Provider Name | Carmen Alejandra Aguayo Morales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639585524 PECOS PAC ID: 9931559929 Enrollment ID: I20240103003103 |
| Provider Name | Karol Owen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245250810 PECOS PAC ID: 2961853700 Enrollment ID: I20240105002964 |
| Provider Name | Haley Brook Walker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811326168 PECOS PAC ID: 7416308275 Enrollment ID: I20240105003684 |
| Provider Name | Nicole Noelle Espey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346438660 PECOS PAC ID: 8527419852 Enrollment ID: I20240110004142 |
| Provider Name | Ronetra Monay Ratcliff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689187973 PECOS PAC ID: 8325490345 Enrollment ID: I20240116001040 |
| Provider Name | Kathryn Scheuer-hopper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336286780 PECOS PAC ID: 2163874199 Enrollment ID: I20240116001367 |
| Provider Name | Chelsea Cheyenne Spears |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639725906 PECOS PAC ID: 1355794702 Enrollment ID: I20240201001390 |
| Provider Name | Deidra Boyken |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932598257 PECOS PAC ID: 2365885977 Enrollment ID: I20240212001219 |
| Provider Name | Stephanie Danielle Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750660650 PECOS PAC ID: 4183068075 Enrollment ID: I20240219003717 |
| Provider Name | Catherine Kaye Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922151869 PECOS PAC ID: 1850736752 Enrollment ID: I20240301001547 |
| Provider Name | Jeffery Wells Broadbent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447717327 PECOS PAC ID: 1052757697 Enrollment ID: I20240306001511 |
| Provider Name | Jennifer Jo Collier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194888172 PECOS PAC ID: 2668818584 Enrollment ID: I20240313002363 |
| Provider Name | Madison Kaylyn Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588246474 PECOS PAC ID: 7214373034 Enrollment ID: I20240314001943 |
| Provider Name | Jaime Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689020521 PECOS PAC ID: 5193163111 Enrollment ID: I20240409004134 |
| Provider Name | Autumn Minch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336630490 PECOS PAC ID: 9133561905 Enrollment ID: I20240524000410 |
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