Provider Demographics
NPI:1457238610
Name:KENTUCKIANA TREATMENT CENTER FOR ANXIETY & OCD LLC
Entity type:Organization
Organization Name:KENTUCKIANA TREATMENT CENTER FOR ANXIETY & OCD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LEINS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:502-341-4742
Mailing Address - Street 1:100 W 3RD ST STE 304
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4129
Mailing Address - Country:US
Mailing Address - Phone:270-238-3566
Mailing Address - Fax:
Practice Address - Street 1:100 W 3RD ST STE 304
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4129
Practice Address - Country:US
Practice Address - Phone:270-238-3566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty