Healthcare Provider Details

I. General information

NPI: 1871128124
Provider Name (Legal Business Name): CHRISTY JO LUMPKINS CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 E ELKINS ST
STANTON KY
40380-2311
US

IV. Provider business mailing address

236 W MAIN ST
MOUNT STERLING KY
40353-1348
US

V. Phone/Fax

Practice location:
  • Phone: 606-663-2511
  • Fax: 606-663-0711
Mailing address:
  • Phone: 859-404-7686
  • Fax: 859-274-4459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number259480
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number255945
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: