Mandala Therapeutic Services

LBN: Mandala Therapeutic Services
Mandala Therapeutic Services is an health care organization with primary practice located at 314 Ferry St , Russell KY 41169-1371. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Agencies / Case Management, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Mandala Therapeutic Services can be contacted via phone (606) 203-2820, or through Smith, Jennifer via phone (606) 388-2898.

Contact Information

Primary practice address
314 Ferry St Russell KY 41169-1371
Phone: (606) 203-2820
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Smith, Jennifer Licensed Clinical Social Worker (LCSW)
Phone: (606) 388-2898

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Agencies / Case Management 251B00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1053878413
LBN Legal business name Mandala Therapeutic Services
DBA Doing business as
Authorized official Smith, Jennifer Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2019
Last updated Apr 22nd, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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