SPECIALIZED THERAPY GROUP LLC NPI 1336404912

NPI Information

NPI: 1336404912
Provider Name: SPECIALIZED THERAPY GROUP, LLC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
340 17TH ST
ASHLAND, KY
ZIP 41101
Phone: (606) 420-4070
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SPECIALIZED THERAPY GROUP, LLC is an addiction (substance use disorder) counselor in Ashland, KY. SPECIALIZED THERAPY GROUP, LLC NPI is 1336404912. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

340 17TH ST
ASHLAND, KY
ZIP 41101-628
Phone: (606) 420-4070
Fax: (606) 420-4071

The provider's authorized official is William Edward Carter .
The authorized official title is Co-founder and has the following contact phone number (606) 420-4070.

The enumeration date for this NPI number is 7/10/2012 and was last updated on 1/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	0864	KENTUCKY	No
2	261QX0100X	Clinic/Center	Occupational Medicine	29912	KENTUCKY	No
3	2084P0800X	Psychiatry & Neurology	Psychiatry			No
4	101YA0400X	Counselor	Addiction (Substance Use Disorder)	RI-C1112181215		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	64106826	MEDICAID	KENTUCKY
2	H45449	MEDICARE UPIN	KENTUCKY
3	1971901	MEDICARE PIN	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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