| Old Town Counseling Of Newburgh Llc | |
|
4333 Old State Route 261 Newburgh IN 47630-2652 | |
| (507) 491-8887 | |
| Not Available |
| Full Name | Old Town Counseling Of Newburgh Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4333 Old State Route 261, Newburgh, Indiana |
| Authorized Official Name and Position | Kelly Kopatich (OWNER) |
| Authorized Official Contact | 5074918887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Town Counseling Of Newburgh Llc Po Box 1114 Newburgh IN 47629-1114 Ph: (507) 491-8887 | Old Town Counseling Of Newburgh Llc 4333 Old State Route 261 Newburgh IN 47630-2652 Ph: (507) 491-8887 |
| NPI Number | 1891366936 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 07/09/2021 |
| Certification Date | 06/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891366936 | NPI | - | NPPES |
| 34008915A | Other | IN | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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