Individual provider · Type 1 NPI
Dylan Blade Nicholas, KCPSS
Peer Specialist · Campbellsville, KY
NPI number
1073380184
Active
Practice location
451 Quisenberry Rd
Campbellsville, KY 42718-8005
Mailing address
109 Kensington Way
Campbellsville, KY 42718-9548
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Peer Specialist Primary | 175T00000X | 1208146 (KY) |
Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
3 other providers at this address
Other peer specialist providers in Campbellsville
About NPI 1073380184
Dylan Blade Nicholas, KCPSS's National Provider Identifier is 1073380184, issued on Dec 8, 2023. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Campbellsville, KY. The record was last updated on Dec 8, 2023.