Healthcare Provider Details

I. General information

NPI: 1245540707
Provider Name (Legal Business Name): KATHY LYNN LUKEY LISW-S, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 DIXIE HWY
FT WRIGHT KY
41011-2766
US

IV. Provider business mailing address

127 GRANT PARK DR
DAYTON KY
41074-1745
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-7453
  • Fax:
Mailing address:
  • Phone: 859-462-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0009199
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberKY.1361
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: