Healthcare Provider Details

I. General information

NPI: 1306270335
Provider Name (Legal Business Name): LEXINGTON THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 DARBY CREEK RD SUITE 50
LEXINGTON KY
40509-1604
US

IV. Provider business mailing address

501 DARBY CREEK RD SUITE 50
LEXINGTON KY
40509-1604
US

V. Phone/Fax

Practice location:
  • Phone: 859-937-1707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0737
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0614
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3344
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1423
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3541
License Number StateKY
# 6
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0738
License Number StateKY

VIII. Authorized Official

Name: KARA F MCDONALD
Title or Position: CO-OWNER
Credential: LMFT
Phone: 859-937-1707