Provider Demographics
NPI:1013344084
Name:RESTORATION COUNSELING
Entity Type:Organization
Organization Name:RESTORATION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MAE, LMFT
Authorized Official - Phone:270-846-3222
Mailing Address - Street 1:1830 DESTINY LN
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-1087
Mailing Address - Country:US
Mailing Address - Phone:270-846-3222
Mailing Address - Fax:270-846-3228
Practice Address - Street 1:1830 DESTINY LN
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-1087
Practice Address - Country:US
Practice Address - Phone:270-846-3222
Practice Address - Fax:270-846-3228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0756251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100230130Medicaid
KY7100230140Medicaid