Healthcare Provider Details

I. General information

NPI: 1790666865
Provider Name (Legal Business Name): BEHAVIORAL AND ADDICTION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E REYNOLDS RD STE 9
LEXINGTON KY
40517-1245
US

IV. Provider business mailing address

717 ROSSLYNS DL
LEXINGTON KY
40514-1189
US

V. Phone/Fax

Practice location:
  • Phone: 859-705-7770
  • Fax:
Mailing address:
  • Phone: 859-436-5174
  • Fax: 714-604-1767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MAGDALEN K MEKOH
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 859-705-7770