Healthcare Provider Details

I. General information

NPI: 1497462204
Provider Name (Legal Business Name): KERRI LEIGH THOMAS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 05/19/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 CENTRAL AVE
ASHLAND KY
41101-7423
US

IV. Provider business mailing address

2901 PIGEON ROOST RD
RUSH KY
41168-8132
US

V. Phone/Fax

Practice location:
  • Phone: 606-547-4400
  • Fax: 606-547-4180
Mailing address:
  • Phone: 606-928-6648
  • Fax: 606-928-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number277177
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: