Provider Demographics
NPI:1609271832
Name:INTERLINK COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:INTERLINK COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CREIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD OF PHILOSOPHY
Authorized Official - Phone:502-889-6140
Mailing Address - Street 1:8311 PRESTON HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-5309
Mailing Address - Country:US
Mailing Address - Phone:502-964-7147
Mailing Address - Fax:502-964-2242
Practice Address - Street 1:8311 PRESTON HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-5309
Practice Address - Country:US
Practice Address - Phone:502-964-7147
Practice Address - Fax:502-964-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY810211324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility