Provider Demographics
NPI: | 1417324989 |
---|---|
Name: | MINDSIGHT PLLC |
Entity type: | Organization |
Organization Name: | MINDSIGHT PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KASEY |
Authorized Official - Middle Name: | RENEE |
Authorized Official - Last Name: | COMPTON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPCC |
Authorized Official - Phone: | 606-401-2966 |
Mailing Address - Street 1: | PO BOX 3932 |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST SOMERSET |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 42564-3932 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 606-401-2966 |
Mailing Address - Fax: | 606-451-9624 |
Practice Address - Street 1: | 600 MONTICELLO ST STE 2 |
Practice Address - Street 2: | |
Practice Address - City: | SOMERSET |
Practice Address - State: | KY |
Practice Address - Zip Code: | 42501-2974 |
Practice Address - Country: | US |
Practice Address - Phone: | 606-401-2966 |
Practice Address - Fax: | 606-244-4111 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-08-31 |
Last Update Date: | 2024-04-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KY | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |