| Mental Awakening Counseling, Llc | |
|
2950 Breckenridge Ln Ste 10a Louisville KY 40220-1495 | |
| (502) 689-1613 | |
| (502) 242-0086 |
| Full Name | Mental Awakening Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2950 Breckenridge Ln Ste 10a, Louisville, Kentucky |
| Authorized Official Name and Position | Robin Lynn Jordan (OWNER AND PROVIDER) |
| Authorized Official Contact | 5026891613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Awakening Counseling, Llc 2950 Breckenridge Ln Ste 10a Louisville KY 40220-1495 Ph: (502) 689-1613 | Mental Awakening Counseling, Llc 2950 Breckenridge Ln Ste 10a Louisville KY 40220-1495 Ph: (502) 689-1613 |
| NPI Number | 1659084630 |
|---|---|
| Provider Enumeration Date | 01/04/2023 |
| Last Update Date | 01/04/2023 |
| Certification Date | 01/04/2023 |
| Medicare PECOS PAC ID | 4385016534 |
|---|---|
| Medicare Enrollment ID | O20230216000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659084630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robin L Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568836997 PECOS PAC ID: 5294107447 Enrollment ID: I20230216000149 |
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