Provider Demographics
NPI:1073962874
Name:MY TIME COUNSELING SERVICES FOR PROFESSIONALS, P.L.L.C.
Entity Type:Organization
Organization Name:MY TIME COUNSELING SERVICES FOR PROFESSIONALS, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, HS-BCP, NCC
Authorized Official - Phone:606-505-8649
Mailing Address - Street 1:383 SALS BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:EVARTS
Mailing Address - State:KY
Mailing Address - Zip Code:40828-6484
Mailing Address - Country:US
Mailing Address - Phone:606-505-8649
Mailing Address - Fax:
Practice Address - Street 1:383 SALS BRANCH RD
Practice Address - Street 2:
Practice Address - City:EVARTS
Practice Address - State:KY
Practice Address - Zip Code:40828-6484
Practice Address - Country:US
Practice Address - Phone:606-505-8649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY103105302R00000X, 305R00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No305S00000XManaged Care OrganizationsPoint of Service