Healthcare Provider Details

I. General information

NPI: 1255235610
Provider Name (Legal Business Name): JAMIE ROUTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 W LOUDON AVE
LEXINGTON KY
40508-1272
US

IV. Provider business mailing address

298 W LOUDON AVE
LEXINGTON KY
40508-1272
US

V. Phone/Fax

Practice location:
  • Phone: 859-721-0149
  • Fax: 859-721-0147
Mailing address:
  • Phone: 859-721-0149
  • Fax: 859-721-0147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number285762
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: