Provider Demographics
NPI:1477135655
Name:GREATER OWENSBORO COUNSELING PARTNERS INC
Entity Type:Organization
Organization Name:GREATER OWENSBORO COUNSELING PARTNERS INC
Other - Org Name:GREATER OWENSBORO COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-557-6396
Mailing Address - Street 1:4531 HWY 54 STE 1
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-2486
Mailing Address - Country:US
Mailing Address - Phone:270-240-4425
Mailing Address - Fax:270-228-4252
Practice Address - Street 1:4531 HWY 54 STE 1
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-2486
Practice Address - Country:US
Practice Address - Phone:270-240-4425
Practice Address - Fax:270-228-4252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty