Sperlisha Victoria Ayeni

Individual provider Active NPI Peer Specialist · Elizabethtown, KY

NPI 1750979746 · NPPES record last updated Jan 5, 2021

Key facts

NPI
1750979746
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
401 N Miles St # B101
Elizabethtown, KY 42701-1834
Phone
(270) 572-4132
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
W I N G S Community Support & Recovery Services Peer Specialist Current
since Jan 10, 2021
Accepting new patients
DDM Case Management Services LLC Current Accepting new patients

Locations

401 N Miles St
#B101
Elizabethtown, KY 42701
Phone (270) 572-4132

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

401 N Miles St # B101
Elizabethtown, KY 42701-1834

Mailing address

5360 Sonora Rd
Hodgenville, KY 42748-9663
Phone (270) 363-8394

Other providers in Elizabethtown, KY

All providers in Elizabethtown, KY · Peer Specialist in Kentucky

Sources for this page

Verify at the official NPI Registry.