Provider Demographics
NPI:1629519921
Name:TRUE TO YOU COUNSELING SERVICE LLC
Entity Type:Organization
Organization Name:TRUE TO YOU COUNSELING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LCADC
Authorized Official - Phone:859-212-6806
Mailing Address - Street 1:126 E EVELYN AVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-1210
Mailing Address - Country:US
Mailing Address - Phone:859-212-6806
Mailing Address - Fax:606-348-0440
Practice Address - Street 1:126 E EVELYN AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633
Practice Address - Country:US
Practice Address - Phone:859-212-6806
Practice Address - Fax:606-348-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY166605251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100374120Medicaid