| S & S Behavioral Health, LLC | |
|
1907 E Pittsburg Church Rd London KY 40741-9047 | |
| (606) 389-5269 | |
| (606) 389-5276 |
| Full Name | S & S Behavioral Health, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1907 E Pittsburg Church Rd, London, Kentucky |
| Authorized Official Name and Position | Stephanie Short (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6063895269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S & S Behavioral Health, LLC 1907 E Pittsburg Church Rd London KY 40741-9047 Ph: (606) 389-5269 | S & S Behavioral Health, LLC 1907 E Pittsburg Church Rd London KY 40741-9047 Ph: (606) 389-5269 |
| NPI Number | 1619612231 |
|---|---|
| Provider Enumeration Date | 04/28/2022 |
| Last Update Date | 06/03/2024 |
| Certification Date | 06/03/2024 |
| Medicare PECOS PAC ID | 2163803255 |
|---|---|
| Medicare Enrollment ID | O20220720003672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619612231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 364SP0808X | Clinical Nurse Specialist - Psychiatric/mental Health | () | Secondary |
| Provider Name | Janice J Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629459409 PECOS PAC ID: 5496065831 Enrollment ID: I20151113002298 |
| Provider Name | Stephanie Short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154728251 PECOS PAC ID: 9436405867 Enrollment ID: I20180627002114 |
| Provider Name | Samantha Nicole Reid |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093050015 PECOS PAC ID: 7618365644 Enrollment ID: I20240828004098 |
| Provider Name | Breanna Rena Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831996099 PECOS PAC ID: 2163915091 Enrollment ID: I20251201000368 |
| Provider Name | Destiny Lace Blue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376495036 PECOS PAC ID: 5698243699 Enrollment ID: I20260507003439 |
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