Destiny Adult, Child & Family Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DESTINY ADULT, CHILD & FAMILY SERVICES LLC

Practice address

701 Dishman Lane Ext Ste 3
Bowling Green, KY 42104-4033

Phone

(270) 495-1609

Fax

(270) 599-0399

NPI assigned

Oct 16, 2011

Organization subpart

No

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

Authorized official

Name

Mark Wade Watson

Title

Owner/Director of Operations

Phone

(270) 202-3595

Specialties & licenses 1

Addresses

Tax ID family

Carolyn Kates-Glass MSW LCSW2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Carolyn Kates-Glass, MSW, LCSW

  • Clinical Social Worker
  • Bowling Green, KY
  • NPI 1346696143
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolyn Kates-Glass

  • Clinical Social Worker
  • Bowling Green, KY
  • NPI 1043503022
  NPD (past)

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

{
    "created_epoch": "1318723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1497030928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DISHMAN LANE EXT STE 3",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044033",
            "telephone_number": "270-495-1609",
            "fax_number": "270-599-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DISHMAN LANE EXT STE 3",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044033",
            "telephone_number": "270-495-1609",
            "fax_number": "270-599-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY ADULT, CHILD & FAMILY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-16",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "270-202-3595"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dependable Senior Care, LLC
• Rasesh Desai, M.D.
• James William Despain, MAE, LPCC
• Patricia Louise Desrosiers, LCSW
• Destiny Adult Day Training LLC
• Susan Diane Devine, T.V.I.
• Megan Lynn Devore, M.S., CCC-SLP
• Paula Devore, APRN
• Kevin D Dew, M.D.
• Andrea N Dexter, MPT

• All providers in Bowling Green, KY
• Community/Behavioral Health Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.