Doctor Name: | GENEVA MABRY |
NPI Number: | 1710355953 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCA |
License Number: | LPCCCA00220342 |
Business Practice Address: | 587 Salyers Branch Rd Sandy Hook, KY - 411717398 |
Business Phone Number: | 6067386368 |
Business Fax Number: | |
Mailing Address: | 587 Salyers Branch Rd, SANDY HOOK |
State: | KY |
Postal Code: | 411717398 |
Phone Number: | 6067386368 |
Fax Number: | |
NPI Enumeration Date: | 09/04/2015 |
NPI Last Update Date: | 09/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPCCCA00220342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |