Healthcare Provider Details

I. General information

NPI: 1881789634
Provider Name (Legal Business Name): LEXINGTON COUNSELING AND PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 DARBY CREEK #11
LEXINGTON KY
40509
US

IV. Provider business mailing address

501 DARBY CREEK RD SUITE 11
LEXINGTON KY
40509-1604
US

V. Phone/Fax

Practice location:
  • Phone: 859-338-0466
  • Fax: 859-294-0802
Mailing address:
  • Phone: 859-338-0466
  • Fax: 859-294-0802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberKY 302
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberKY 302
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberKY 1332
License Number StateKY

VIII. Authorized Official

Name: PAUL DAVID DALTON
Title or Position: PRESIDENT
Credential:
Phone: 859-338-0466