| Community Based Interventions | |
|
80 Rolling Hills Blvd Monticello KY 42633-9005 | |
| (606) 343-0216 | |
| (606) 343-0224 |
| Full Name | Community Based Interventions |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 80 Rolling Hills Blvd, Monticello, Kentucky |
| Authorized Official Name and Position | Samantha Ann Simmons (DIRECTOR) |
| Authorized Official Contact | 6063430216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Based Interventions 80 Rolling Hills Blvd Monticello KY 42633-9005 Ph: (606) 343-0216 | Community Based Interventions 80 Rolling Hills Blvd Monticello KY 42633-9005 Ph: (606) 343-0216 |
| NPI Number | 1114291879 |
|---|---|
| Provider Enumeration Date | 02/28/2012 |
| Last Update Date | 05/14/2021 |
| Medicare PECOS PAC ID | 5698027563 |
|---|---|
| Medicare Enrollment ID | O20181004002039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114291879 | NPI | - | NPPES |
| 7100317630 | Medicaid | KY |
| Provider Name | Anthony L Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437663630 PECOS PAC ID: 5395094916 Enrollment ID: I20180815001412 |
| Provider Name | Shelby Lynn Delk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497432850 PECOS PAC ID: 9739542648 Enrollment ID: I20230824003863 |
| Provider Name | Lucy Namulemo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043082175 PECOS PAC ID: 9133572019 Enrollment ID: I20240126002103 |
| Provider Name | Samantha Ann Simmons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629123625 PECOS PAC ID: 8022360999 Enrollment ID: I20240126003302 |
| Provider Name | Lee Parrigin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306269626 PECOS PAC ID: 4284087123 Enrollment ID: I20240127000217 |
| Provider Name | Keisha C Hubbs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780453472 PECOS PAC ID: 0547613481 Enrollment ID: I20240127000238 |
| Provider Name | Carla Jean Groce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861814899 PECOS PAC ID: 0941653893 Enrollment ID: I20240127000495 |
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