| Mended Counseling & Trauma Services Llc | |
|
824 Euclid Ave Ste A102 Lexington KY 40502-1785 | |
| (859) 338-0006 | |
| Not Available |
| Full Name | Mended Counseling & Trauma Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 824 Euclid Ave Ste A102, Lexington, Kentucky |
| Authorized Official Name and Position | Jessie Dayton (OWNER) |
| Authorized Official Contact | 8594290860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mended Counseling & Trauma Services Llc 824 Euclid Ave Ste A102 Lexington KY 40502-1785 Ph: () - | Mended Counseling & Trauma Services Llc 824 Euclid Ave Ste A102 Lexington KY 40502-1785 Ph: (859) 338-0006 |
| NPI Number | 1932863073 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 04/01/2024 |
| Certification Date | 04/01/2024 |
| Medicare PECOS PAC ID | 8325423742 |
|---|---|
| Medicare Enrollment ID | O20220920003232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932863073 | NPI | - | NPPES |
| 7100722810 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ashleigh Michelle Gasparac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912386418 PECOS PAC ID: 6901206960 Enrollment ID: I20210611001940 |
| Provider Name | Anthony Michael Meza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306421243 PECOS PAC ID: 7315312105 Enrollment ID: I20230410000781 |
| Provider Name | Stacey Keliher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669158754 PECOS PAC ID: 9739548652 Enrollment ID: I20230710002225 |
| Provider Name | Jessie Dayton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043753296 PECOS PAC ID: 9234514654 Enrollment ID: I20240123004520 |
Alexander J. Tikhtman, M.d., P.s.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1517 Nicholasville Rd, Suite 403, Lexington, KY 40503 Phone: 859-276-6168 Fax: 859-276-0850 | |
Verbal Behavior Consulting, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 Strader Dr Ste 150, Lexington, KY 40505 Phone: 859-899-9200 Fax: 859-899-9202 | |
Thomas-peeples & Associates, Psc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Dennis Dr, Lexington, KY 40503 Phone: 859-278-4775 Fax: 859-373-0018 | |
Kvc Behavorial Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Beasley St, Lexington, KY 40509 Phone: 859-254-1035 | |
Momo Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 162 Glenn Pl, Lexington, KY 40505 Phone: 502-509-9436 | |
Andre N. Fernandez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Darby Creek Rd, Suite 21, Lexington, KY 40509 Phone: 859-263-9305 Fax: 859-264-1169 | |
Mended Counseling & Trauma Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 824 Euclid Ave Ste A102, Lexington, KY 40502 Phone: 859-338-0006 |