| Hope | |
|
106 Cemetery Rd Lebanon KY 40033-1827 | |
| (270) 401-1104 | |
| Not Available |
| Full Name | Hope |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 106 Cemetery Rd, Lebanon, Kentucky |
| Authorized Official Name and Position | Tammy Lynn Mattingly (OWNER) |
| Authorized Official Contact | 2704025601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope 106 Cemetery Rd Lebanon KY 40033-1827 Ph: (270) 401-1104 | Hope 106 Cemetery Rd Lebanon KY 40033-1827 Ph: (270) 401-1104 |
| NPI Number | 1356893630 |
|---|---|
| Provider Enumeration Date | 11/02/2016 |
| Last Update Date | 12/17/2020 |
| Certification Date | 12/17/2020 |
| Medicare PECOS PAC ID | 6305259912 |
|---|---|
| Medicare Enrollment ID | O20201228001722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356893630 | NPI | - | NPPES |
| Provider Name | Brittanie Landis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356896211 PECOS PAC ID: 1456774975 Enrollment ID: I20200630003187 |
| Provider Name | Mary K Miles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235485707 PECOS PAC ID: 4284047622 Enrollment ID: I20210104002013 |
| Provider Name | Martie B Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306468350 PECOS PAC ID: 2961841861 Enrollment ID: I20240411001754 |
| Provider Name | Tammy Mattingly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063776037 PECOS PAC ID: 0749693182 Enrollment ID: I20240412000479 |
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