Healthcare Provider Details

I. General information

NPI: 1104028042
Provider Name (Legal Business Name): NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 FARRELL DR
COVINGTON KY
41011-3717
US

IV. Provider business mailing address

503 FARRELL DR
COVINGTON KY
41011-3775
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-3292
  • Fax:
Mailing address:
  • Phone: 859-578-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE AMRINE
Title or Position: PRESIDENT/CEO
Credential: LSW
Phone: 859-578-3200