Provider Demographics
NPI:1982393781
Name:WOLF CREEK COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:WOLF CREEK COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINWATER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, NCC
Authorized Official - Phone:606-872-2977
Mailing Address - Street 1:14987 W HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:NANCY
Mailing Address - State:KY
Mailing Address - Zip Code:42544-9020
Mailing Address - Country:US
Mailing Address - Phone:606-872-2977
Mailing Address - Fax:
Practice Address - Street 1:14987 W HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:NANCY
Practice Address - State:KY
Practice Address - Zip Code:42544-9020
Practice Address - Country:US
Practice Address - Phone:606-872-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty