Provider Demographics
| NPI: | 1740919281 |
|---|---|
| Name: | AIDAN BEHAVIORAL HEALTH & CONSULTING, LLC |
| Entity type: | Organization |
| Organization Name: | AIDAN BEHAVIORAL HEALTH & CONSULTING, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CLINICAL PSYCHOLOGIST |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | DARLENE |
| Authorized Official - Middle Name: | MARIE |
| Authorized Official - Last Name: | DAVIS GOODWINE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LP, LCADC, CAADC |
| Authorized Official - Phone: | 502-276-5096 |
| Mailing Address - Street 1: | 1030 BURLINGTON LANE |
| Mailing Address - Street 2: | SUITE 5 |
| Mailing Address - City: | FRANKFORT |
| Mailing Address - State: | KY |
| Mailing Address - Zip Code: | 40601 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 502-276-5096 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1030 BURLINGTON LANE |
| Practice Address - Street 2: | SUITE 5 |
| Practice Address - City: | FRANKFORT |
| Practice Address - State: | KY |
| Practice Address - Zip Code: | 40601 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 502-276-5096 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-06-09 |
| Last Update Date: | 2022-06-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
| No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
