| Recapture Recovery Llc | |
|
1015 W Lexington Ave Winchester KY 40391-1241 | |
| (859) 644-5046 | |
| Not Available |
| Full Name | Recapture Recovery Llc |
|---|---|
| Speciality | Counselor |
| Location | 1015 W Lexington Ave, Winchester, Kentucky |
| Authorized Official Name and Position | Lori Lynette Couch (OWNER) |
| Authorized Official Contact | 8596445046 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Recapture Recovery Llc 6428 Veterans Memorial Hwy Sharpsburg KY 40374-8001 Ph: (859) 585-3777 | Recapture Recovery Llc 1015 W Lexington Ave Winchester KY 40391-1241 Ph: (859) 644-5046 |
| NPI Number | 1053060210 |
|---|---|
| Provider Enumeration Date | 03/23/2022 |
| Last Update Date | 10/21/2022 |
| Certification Date | 10/21/2022 |
| Medicare PECOS PAC ID | 4789064361 |
|---|---|
| Medicare Enrollment ID | O20221108001669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053060210 | NPI | - | NPPES |
| 7100816720 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Stacy L Mccune |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093858722 PECOS PAC ID: 2365692407 Enrollment ID: I20121025000302 |
| Provider Name | Crystal Mobley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568612414 PECOS PAC ID: 5496188021 Enrollment ID: I20191211003344 |
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