Healthcare Provider Details

I. General information

NPI: 1659207702
Provider Name (Legal Business Name): ALLIE HEAD CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 US HIGHWAY 60 W
MOREHEAD KY
40351-9271
US

IV. Provider business mailing address

2020 ARMSTRONG MILL RD APT 1824
LEXINGTON KY
40515-7555
US

V. Phone/Fax

Practice location:
  • Phone: 859-551-1778
  • Fax:
Mailing address:
  • Phone: 859-270-0545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW00001464
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: