Provider Demographics
NPI:1568923969
Name:KATHY TICHENOR COUNSELING LLC
Entity Type:Organization
Organization Name:KATHY TICHENOR COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:TICHENOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:270-339-5670
Mailing Address - Street 1:769 LEGION DR STE D
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-3109
Mailing Address - Country:US
Mailing Address - Phone:270-339-5670
Mailing Address - Fax:
Practice Address - Street 1:190 MADISON SQUARE DR STE D
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2785
Practice Address - Country:US
Practice Address - Phone:270-339-5670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty