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General NPI Number Information
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NPI Number | 1063029429
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Entity Type | Organization
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Legal Business Name | PAFF MENTAL HEALTH
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 236 E REYNOLDS RD STE C2
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City | LEXINGTON
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State | KY
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Zip | 40517-1273
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Country | US
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Telephone | 859-359-8585
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Fax | 859-787-0549
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Provider Business Mailing Address
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Address Line | 236 E REYNOLDS RD STE C2
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City | LEXINGTON
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State | KY
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Zip | 40517-1273
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Country | US
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Telephone | 859-359-8585
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Fax | 859-787-0549
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Authorized Official
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Title or Position | OWNER
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Name | KAY HUBBARD
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Credential | LCSW
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Telephone | 859-619-9582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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