Dylan Blade Nicholas, KCPSS - Campbellsville, KY

Dylan Blade Nicholas, KCPSS

Peer Specialist in Campbellsville, Kentucky

NPI 1073380184

Dylan Blade Nicholas is a Peer Specialist based in Campbellsville, KY. Dylan Blade Nicholas practices in Campbellsville, KY and has the professional credentials of KCPSS. The NPI Number for Dylan Blade Nicholas is 1073380184 and holds a License No. 1208146 (Kentucky).

The current practice location address for Dylan Blade Nicholas is 451 Quisenberry Rd, Campbellsville, KY and can be reached out via phone at 270-937-4898.

Location: 451 Quisenberry Rd, Campbellsville, KY, 42718-9548

NPI Number

1073380184

Provider Name

Dylan Blade Nicholas

Credential

KCPSS

Provider Entity Type

Individual

Gender

Male

Address

451 Quisenberry Rd, Campbellsville, KY, 42718-9548

Phone Number

270-937-4898

Fax Number

Provider Enumeration Date

12/08/2023

Last Update Date

03/10/2024

Address

451 Quisenberry Rd

City

Campbellsville

State

Kentucky

Zip

42718-8005

Phone Number

270-937-4898

Fax Number

Address

451 Quisenberry Rd

City

Campbellsville

State

Kentucky

Zip

42718-8005

Phone Number

270-937-4898

Fax Number

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

License No.

1208146 (Kentucky)

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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