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Therapeutic Collaborative
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Wilder, Kentucky
NPI 1629123443

Therapeutic Collaborative is a Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist based in Wilder, KY and is specialized in Psychiatric/Mental Health, Child & Adolescent. Therapeutic Collaborative practices in Wilder, KY. The NPI Number for Therapeutic Collaborative is 1629123443 and holds a License No. (Kentucky).

The current practice location address for Therapeutic Collaborative is 519 Licking Pike, Wilder, KY and can be reached out via phone at 859-572-0400 and via fax at 859-442-3363.

Location: 519 Licking Pike, Wilder, KY, 41071
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629123443
Provider Name
Therapeutic Collaborative
Credential
Provider Entity Type
Organization
Address
519 Licking Pike, Wilder, KY, 41071
Phone Number
859-572-0400
Fax Number
859-442-3363
Provider Enumeration Date
01/24/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
65928897 05 KY
institution
Provider Business Practice Location Address Details
Address
519 Licking Pike
City
Wilder
State
Kentucky
Zip
41071
Phone Number
859-572-0400
Fax Number
859-442-3363
person
Provider Business Mailing Address Details
Address
519 Licking Pike
City
Wilder
State
Kentucky
Zip
41071
Phone Number
859-572-0400
Fax Number
859-442-3363
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Psychiatric/Mental Health, Child & Adolescent
Taxonomy
364SP0807X
License No.
()
Definition
Definition to come...
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