Screen Door Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

171215 Issued in KY

Legal business name

SCREEN DOOR COUNSELING, LLC

Practice address

400 E Main Ave
Suite 309
Bowling Green, KY 42101-6900

Phone

(270) 307-1935

NPI assigned

Apr 6, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amber Rahim

Title

Owner

Phone

(270) 307-1935

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1376907378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E MAIN AVE",
            "address_2": "SUITE 309",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421016900",
            "telephone_number": "270-307-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN AVE",
            "address_2": "SUITE 309",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421016900",
            "telephone_number": "270-307-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCREEN DOOR COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "RAHIM",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-307-1935"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "171215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.