Provider Demographics
NPI:1821166042
Name:HEARTLAND COUNSELING SERVICES PSC
Entity Type:Organization
Organization Name:HEARTLAND COUNSELING SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR CLINICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:LUTHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:270-763-6644
Mailing Address - Street 1:806 N MULBERRY STREET
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701
Mailing Address - Country:US
Mailing Address - Phone:270-763-6644
Mailing Address - Fax:270-737-4069
Practice Address - Street 1:806 N MULBERRY STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701
Practice Address - Country:US
Practice Address - Phone:270-763-6644
Practice Address - Fax:270-737-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0301101YA0400X
KYKY0057101YM0800X
MIMI6401004980101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty