| Vivid Mind Behavioral Health Llc | |
|
228 Leras Way Somerset KY 42501-4919 | |
| (502) 694-2251 | |
| Not Available |
| Full Name | Vivid Mind Behavioral Health Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 228 Leras Way, Somerset, Kentucky |
| Authorized Official Name and Position | Tammy Wright (OWNER) |
| Authorized Official Contact | 5026942251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivid Mind Behavioral Health Llc 228 Leras Way Somerset KY 42501-4919 Ph: () - | Vivid Mind Behavioral Health Llc 228 Leras Way Somerset KY 42501-4919 Ph: (502) 694-2251 |
| NPI Number | 1457003006 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 02/28/2022 |
| Certification Date | 02/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457003006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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