Healthcare Provider Details

I. General information

NPI: 1942738349
Provider Name (Legal Business Name): NIKKI LEE LAYNE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 9
MAYKING KY
41837-0009
US

IV. Provider business mailing address

PO BOX 9
MAYKING KY
41837-0009
US

V. Phone/Fax

Practice location:
  • Phone: 606-658-0710
  • Fax: 606-658-0720
Mailing address:
  • Phone: 606-658-0710
  • Fax: 606-658-0720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number295359
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number295359
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: