Provider Demographics
NPI:1124792833
Name:NLC CONSULTING SERVICES, LLC.
Entity type:Organization
Organization Name:NLC CONSULTING SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:LASHAN
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S, MAC, CCCE
Authorized Official - Phone:859-312-3744
Mailing Address - Street 1:PO BOX 11851
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40578-1851
Mailing Address - Country:US
Mailing Address - Phone:859-317-9558
Mailing Address - Fax:859-406-1066
Practice Address - Street 1:431 S BROADWAY STE 121
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2955
Practice Address - Country:US
Practice Address - Phone:859-317-9558
Practice Address - Fax:859-406-1066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100857890Medicaid