| Mental Health & Wellness Center, Llc | |
|
125 Orchard Dr Nicholasville KY 40356-2690 | |
| (859) 241-3081 | |
| (859) 241-1045 |
| Full Name | Mental Health & Wellness Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 125 Orchard Dr, Nicholasville, Kentucky |
| Authorized Official Name and Position | Carol R Loose (OWNER/CLINICAL THERAPIST) |
| Authorized Official Contact | 8592413081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health & Wellness Center, Llc 125 Orchard Dr Nicholasville KY 40356-2690 Ph: () - | Mental Health & Wellness Center, Llc 125 Orchard Dr Nicholasville KY 40356-2690 Ph: (859) 241-3081 |
| NPI Number | 1548779556 |
|---|---|
| Provider Enumeration Date | 09/21/2017 |
| Last Update Date | 11/08/2018 |
| Medicare PECOS PAC ID | 6709143316 |
|---|---|
| Medicare Enrollment ID | O20171206000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548779556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Jennifer E Knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306269139 PECOS PAC ID: 1850669722 Enrollment ID: I20170727003972 |
| Provider Name | Carol R Loose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407279318 PECOS PAC ID: 8325305931 Enrollment ID: I20171206000779 |
| Provider Name | Lee-anne M Vaughn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124556634 PECOS PAC ID: 0143587758 Enrollment ID: I20171206000882 |
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