Provider Demographics
NPI:1639900186
Name:AMAZING OPPORTUNITY OF LEXINGTON, LLC
Entity type:Organization
Organization Name:AMAZING OPPORTUNITY OF LEXINGTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DELMETRIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CAYSON COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:859-545-8520
Mailing Address - Street 1:197 OLD WOOLEN MILL LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-7005
Mailing Address - Country:US
Mailing Address - Phone:270-849-5898
Mailing Address - Fax:
Practice Address - Street 1:501 DARBY CREEK RD STE 1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1605
Practice Address - Country:US
Practice Address - Phone:859-545-8520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty