Time Out Community Counseling and Correctional Services, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0531 Issued in KY

Legal business name

TIME OUT COMMUNITY COUNSELING AND CORRECTIONAL SERVICES, LLC

Practice address

1502 Park City Glasgow Rd
Glasgow, KY 42141-7209

Phone

(270) 678-3138

NPI assigned

Sep 14, 2010

Last updated

Sep 23, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Sue Farley, RN

Title

Office Manager/Educator

Phone

(270) 237-3463

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1558679480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W PUBLIC SQ",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421641175",
            "telephone_number": "270-237-3463",
            "fax_number": "270-237-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 PARK CITY GLASGOW RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421417209",
            "telephone_number": "270-678-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIME OUT COMMUNITY COUNSELING AND CORRECTIONAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER/EDUCATOR",
        "authorized_official_telephone_number": "270-237-3463",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "0531",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1107277",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "1107277",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "KY",
            "license": "1107277",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "KY",
            "license": "1107277",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": "810288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.