OrganizationActive
Therapeutic Collaborative
NPI 1629123443 · Adolescent and Children Mental Health Clinic/Center · Wilder, KY
Provider details
- NPI number
- 1629123443
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Virginia Peppers, Partner(859) 572-0400
Specialties & taxonomies
Ambulatory Health Care Facilities
- Adult Mental Health Clinic/Center261QM0850X
Ambulatory Health Care Facilities
Physician Assistants & Advanced Practice Nursing Providers
Practice location
519 Licking Pike
Wilder, KY 41071
Phone: (859) 572-0400
Fax: (859) 442-3363
Approximate (ZIP-level) locationGet directions
Mailing address
519 Licking Pike
Wilder, KY 41071
Registry dates
- Enumerated
- 2007-01-24
- Last updated
- 2011-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.