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General NPI Number Information
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NPI Number | 1396265989
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Entity Type | Organization
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Legal Business Name | KENTUCKY OHANNA INITIATIVE, INC
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1795 ALYSHEBA WAY STE 1001
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City | LEXINGTON
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State | KY
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Zip | 40509-2282
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Country | US
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Telephone | 859-687-0416
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Fax | 859-353-4200
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Provider Business Mailing Address
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Address Line | 1795 ALYSHEBA WAY STE 1001
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City | LEXINGTON
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State | KY
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Zip | 40509-2282
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Country | US
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Telephone | 859-687-0416
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Fax | 859-353-4200
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Authorized Official
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Title or Position | DIRECTOR
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Name | STEVANIE SMITH
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Credential | LPCC, LPCADC, MAC
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Telephone | 859-687-0416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | KY
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