Healthcare Provider Details

I. General information

NPI: 1902414659
Provider Name (Legal Business Name): BRITTANY MCKENZIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY KOUNS

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 INTERSTATE DR
GRAYSON KY
41143-1768
US

IV. Provider business mailing address

PO BOX 790
ASHLAND KY
41105-0790
US

V. Phone/Fax

Practice location:
  • Phone: 606-329-8588
  • Fax:
Mailing address:
  • Phone: 606-329-8588
  • Fax: 606-329-8195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number303612
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: