Provider Demographics
NPI:1568065746
Name:ALLY COUNSELING
Entity Type:Organization
Organization Name:ALLY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:859-338-5559
Mailing Address - Street 1:PO BOX 54235
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40555-4235
Mailing Address - Country:US
Mailing Address - Phone:859-338-5559
Mailing Address - Fax:855-201-2319
Practice Address - Street 1:550 DARBY CREEK RD APT 8
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1619
Practice Address - Country:US
Practice Address - Phone:859-338-5559
Practice Address - Fax:855-201-2319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100476070Medicaid