Provider Demographics
NPI:1912734765
Name:CYPRESS COUNSELING
Entity type:Organization
Organization Name:CYPRESS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:KISHBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:270-820-5065
Mailing Address - Street 1:1937 MUD RIVER UNION RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:KY
Mailing Address - Zip Code:42324-3331
Mailing Address - Country:US
Mailing Address - Phone:270-820-5065
Mailing Address - Fax:
Practice Address - Street 1:1937 MUD RIVER UNION RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:KY
Practice Address - Zip Code:42324-3331
Practice Address - Country:US
Practice Address - Phone:270-820-5065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)