Healthcare Provider Details

I. General information

NPI: 1164473559
Provider Name (Legal Business Name): KENNETH BUCHER LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318-320 MONTJOY STREET
FALMOUTH KY
41040-1132
US

IV. Provider business mailing address

502 FARRELL DR
COVINGTON KY
41011-3717
US

V. Phone/Fax

Practice location:
  • Phone: 859-654-6988
  • Fax:
Mailing address:
  • Phone: 859-331-3292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberKY-0804
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: