Healthcare Provider Details

I. General information

NPI: 1174238877
Provider Name (Legal Business Name): NICHOLAS PRIOR LPCC-S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6489 LAKEARBOR DR
INDEPENDENCE KY
41051-8353
US

IV. Provider business mailing address

6489 LAKEARBOR DR
INDEPENDENCE KY
41051-8353
US

V. Phone/Fax

Practice location:
  • Phone: 859-302-0969
  • Fax:
Mailing address:
  • Phone: 859-302-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number281594
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: