Provider Demographics
NPI:1891837563
Name:FLYNN & OWEN COUNSELING SERVICES
Entity type:Organization
Organization Name:FLYNN & OWEN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:L
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:270-538-0851
Mailing Address - Street 1:5120 VILLAGE SQUARE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-9560
Mailing Address - Country:US
Mailing Address - Phone:270-538-0851
Mailing Address - Fax:270-538-0852
Practice Address - Street 1:5120 VILLAGE SQUARE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9560
Practice Address - Country:US
Practice Address - Phone:270-538-0851
Practice Address - Fax:270-538-0852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7708Medicare ID - Type UnspecifiedMEDICARE GROUP ID