Provider Demographics
NPI:1467408617
Name:MULLINS-COUCH, ALISON PAIGE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:PAIGE
Last Name:MULLINS-COUCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-4476
Mailing Address - Country:US
Mailing Address - Phone:270-881-1062
Mailing Address - Fax:270-887-0785
Practice Address - Street 1:1609 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1970
Practice Address - Country:US
Practice Address - Phone:270-881-1062
Practice Address - Fax:270-887-0785
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY1182103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30602015Medicaid
KY0713402Medicare PIN
KYQ50893Medicare UPIN