John Jerome Flannigan

Individual provider Active NPI Professional Counselor · Brandenburg, KY

NPI 1760067458 · NPPES record last updated Mar 14, 2021

Key facts

NPI
1760067458
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
251722 (KY)
Practice address
230 Valley Greens Rd
Brandenburg, KY 40108-7154
Phone
(502) 321-4847
NPI assigned
Mar 14, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
251722KYMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YP2500X 251722 KY Yes

Addresses

Primary practice location

230 Valley Greens Rd
Brandenburg, KY 40108-7154

Mailing address

230 Valley Greens Rd
Brandenburg, KY 40108-7154
Phone (502) 321-4847

Other providers in Brandenburg, KY

All providers in Brandenburg, KY · Professional Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.