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General NPI Number Information
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NPI Number | 1487570057
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Entity Type | Organization
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Legal Business Name | NORTHERN KENTUCKY BEHAVIORAL, LLC
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 820 DOLWICK DR
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City | ERLANGER
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State | KY
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Zip | 41018-2774
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Country | US
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Telephone | 859-429-5188
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Fax | 859-578-2875
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Provider Business Mailing Address
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Address Line | 820 DOLWICK DR
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City | ERLANGER
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State | KY
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Zip | 41018-2774
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Country | US
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Telephone | 859-429-5188
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Fax | 859-578-2875
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Authorized Official
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Title or Position | DIRECTOR OF PROVIDER CREDENTIALING
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Name | KEANNA MCCLENDON
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Credential |
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Telephone | 678-698-2070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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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 | 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 #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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