Provider Demographics
NPI:1346890134
Name:CTG LIMITED CO
Entity Type:Organization
Organization Name:CTG LIMITED CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CRASE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:606-506-5055
Mailing Address - Street 1:311 N ARNOLD AVE STE 504
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-1279
Mailing Address - Country:US
Mailing Address - Phone:606-226-1530
Mailing Address - Fax:606-506-5073
Practice Address - Street 1:268 E FRIEND ST STE 101
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8071
Practice Address - Country:US
Practice Address - Phone:606-506-5055
Practice Address - Fax:606-506-5073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100425940Medicaid
KY5132OtherLCSW