Phyllis Crockett

Individual provider Active NPI Counselor · Frenchburg, KY

NPI 1427103100 · NPPES record last updated Jul 15, 2015

Key facts

NPI
1427103100
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
70 Main Street
Frenchburg, KY 40322
Phone
(606) 768-2131
Fax
(606) 768-2134
NPI assigned
Jan 24, 2007
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
Counselor 101Y00000X Yes

Addresses

Primary practice location

70 Main Street
Frenchburg, KY 40322

Mailing address

PO Box 790
Ashland, KY 41105-0790
Phone (606) 329-8588

Other identifiers

IdentifierTypeStateIssuer
30610026MedicaidKY

Other providers in Frenchburg, KY

All providers in Frenchburg, KY · Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.