Healthcare Provider Details

I. General information

NPI: 1366376501
Provider Name (Legal Business Name): WILDFLOWER BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 TRIVETTE DR STE 202
PIKEVILLE KY
41501-1275
US

IV. Provider business mailing address

126 TRIVETTE DR STE 202
PIKEVILLE KY
41501-1275
US

V. Phone/Fax

Practice location:
  • Phone: 606-432-6957
  • Fax:
Mailing address:
  • Phone: 606-432-6957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LEIGH ANN FORD
Title or Position: PSYCHOLOGIST
Credential: PSYCHOLOGIST
Phone: 606-432-6957