| In The Scene Wellness Collective Llc | |
|
3499 Blazer Pkwy Ste 440 Lexington KY 40509-2803 | |
| (859) 338-5762 | |
| Not Available |
| Full Name | In The Scene Wellness Collective Llc |
|---|---|
| Speciality | Counselor |
| Location | 3499 Blazer Pkwy Ste 440, Lexington, Kentucky |
| Authorized Official Name and Position | Elizabeth Etherton (OWNER/THERAPIST) |
| Authorized Official Contact | 8593385762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| In The Scene Wellness Collective Llc 996 E New Circle Rd Unit 166 Lexington KY 40505-4127 Ph: (859) 338-5762 | In The Scene Wellness Collective Llc 3499 Blazer Pkwy Ste 440 Lexington KY 40509-2803 Ph: (859) 338-5762 |
| NPI Number | 1609647650 |
|---|---|
| Provider Enumeration Date | 01/09/2024 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Medicare PECOS PAC ID | 7315474301 |
|---|---|
| Medicare Enrollment ID | O20250103000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609647650 | NPI | - | NPPES |
| Provider Name | Elizabeth Lue Suzanne Etherton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760894588 PECOS PAC ID: 8224565213 Enrollment ID: I20250103000595 |
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