Provider Demographics
NPI:1881346492
Name:EAST KENTUCKY COUNSELING ASSOCIATES LLC
Entity type:Organization
Organization Name:EAST KENTUCKY COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VANHOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-731-2024
Mailing Address - Street 1:636 KY ROUTE 993
Mailing Address - Street 2:
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-8576
Mailing Address - Country:US
Mailing Address - Phone:609-791-2024
Mailing Address - Fax:
Practice Address - Street 1:636 KY ROUTE 993
Practice Address - Street 2:
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240-8576
Practice Address - Country:US
Practice Address - Phone:609-791-2024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty