Provider Demographics
NPI:1063040871
Name:NATIONAL TREATMENT PREVENTION AND EDUCATION CENTER
Entity type:Organization
Organization Name:NATIONAL TREATMENT PREVENTION AND EDUCATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LCADC
Authorized Official - Phone:859-583-5750
Mailing Address - Street 1:6452 ALUM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-9054
Mailing Address - Country:US
Mailing Address - Phone:859-553-9030
Mailing Address - Fax:844-596-7495
Practice Address - Street 1:8650 PARK LAUREATE DR APT 216
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-7036
Practice Address - Country:US
Practice Address - Phone:859-583-5750
Practice Address - Fax:844-596-7495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-28
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100478080Medicaid