Lionheart Trauma Support Services, Llc | |
168 E Reynolds Rd. Suite 210 Lexington KY 40517 | |
(859) 314-8786 | |
Not Available |
Full Name | Lionheart Trauma Support Services, Llc |
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Speciality | Social Worker |
Location | 168 E Reynolds Rd., Lexington, Kentucky |
Authorized Official Name and Position | Katherine Linda Middleton (MENTAL HEALTH THERAPIST) |
Authorized Official Contact | 8593148786 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lionheart Trauma Support Services, Llc 168 E. Reynolds Rd. Ste 210 Lexingtion KY 40517 Ph: (859) 314-8786 | Lionheart Trauma Support Services, Llc 168 E Reynolds Rd. Suite 210 Lexington KY 40517 Ph: (859) 314-8786 |
NPI Number | 1538638515 |
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Provider Enumeration Date | 11/19/2018 |
Last Update Date | 11/19/2018 |
Medicare PECOS PAC ID | 5294071429 |
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Medicare Enrollment ID | O20190109002057 |
Identifier | Type | State | Issuer |
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1538638515 | NPI | - | NPPES |
7100479060 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Katherine Middleton |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1043699416 PECOS PAC ID: 0547506776 Enrollment ID: I20190109002177 |
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