Healthcare Provider Details

I. General information

NPI: 1770679813
Provider Name (Legal Business Name): ST. CLAIRE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 CLINIC DR
MOREHEAD KY
40351-1077
US

IV. Provider business mailing address

445 CLINIC DR
MOREHEAD KY
40351-1077
US

V. Phone/Fax

Practice location:
  • Phone: 606-783-6805
  • Fax: 606-783-6869
Mailing address:
  • Phone: 606-783-6805
  • Fax: 606-783-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number740120
License Number StateKY

VIII. Authorized Official

Name: DONALD H LLOYD II
Title or Position: CEO/PRESIDENT
Credential:
Phone: 606-783-6502