Provider Demographics
NPI:1518615566
Name:ATTUNE THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:ATTUNE THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW; LCADC
Authorized Official - Phone:270-216-1662
Mailing Address - Street 1:556 EMMETT AVE APT 59
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-4111
Mailing Address - Country:US
Mailing Address - Phone:270-216-1662
Mailing Address - Fax:
Practice Address - Street 1:310 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2143
Practice Address - Country:US
Practice Address - Phone:270-216-1662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)