Healthcare Provider Details

I. General information

NPI: 1407587694
Provider Name (Legal Business Name): SHANNA LEIGH HUFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHANNA LEIGH AUSTIN LCSW

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 W MAIN ST
LEXINGTON KY
40507-1644
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number256699
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: