Mallory M Bitterman

Individual provider Active NPI Mental Health Counselor · Wilmore, KY

NPI 1356800577 · NPPES record last updated Mar 18, 2019

Key facts

NPI
1356800577
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
124 Asbury Dr
Wilmore, KY 40390-1115
Phone
(765) 480-3259
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

124 Asbury Dr
Wilmore, KY 40390-1115

Mailing address

124 Asbury Dr
Wilmore, KY 40390-1115
Phone (765) 480-3259

Other identifiers

IdentifierTypeStateIssuer
1256MedicaidKY

Electronic endpoints

TypeEndpointUseAffiliation
Other URL mallory.bitterman@asburyseminary.edu

Other providers in Wilmore, KY

All providers in Wilmore, KY · Mental Health Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.