Provider Demographics
NPI:1629663414
Name:ESSENTIAL PEACE COUNSELING, LLC.
Entity Type:Organization
Organization Name:ESSENTIAL PEACE COUNSELING, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:708-280-2068
Mailing Address - Street 1:1550 FALCONS RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-9598
Mailing Address - Country:US
Mailing Address - Phone:708-280-2068
Mailing Address - Fax:
Practice Address - Street 1:1550 FALCONS RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9598
Practice Address - Country:US
Practice Address - Phone:708-280-2068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty