Healthcare Provider Details

I. General information

NPI: 1790739787
Provider Name (Legal Business Name): NORMA KERSEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S CLINTON ST
LEITCHFIELD KY
42754-1492
US

IV. Provider business mailing address

107 CRANES ROOST CT
ELIZABETHTOWN KY
42701-3650
US

V. Phone/Fax

Practice location:
  • Phone: 270-259-4652
  • Fax: 270-259-6655
Mailing address:
  • Phone: 270-765-2605
  • Fax: 270-766-1222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number734
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: