Provider Demographics
NPI:1194593707
Name:ABUNDANT MERCY COUNSELING
Entity type:Organization
Organization Name:ABUNDANT MERCY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:502-203-5901
Mailing Address - Street 1:12700 TOWNEPARK WAY STE 337
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2556
Mailing Address - Country:US
Mailing Address - Phone:502-203-5901
Mailing Address - Fax:
Practice Address - Street 1:12700 TOWNEPARK WAY STE 337
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2556
Practice Address - Country:US
Practice Address - Phone:502-203-5901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty