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General NPI Number Information
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NPI Number | 1548353386
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Entity Type | Individual
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Provider Name | KELLYE DAIR LEDBETTER MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 328 THOMAS MORE PARKWAY UNIT 102
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-431-6333
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Fax | 859-341-0310
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Provider Business Mailing Address
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Address Line | 328 THOMAS MORE PARKWAY UNIT 102
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-431-6333
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Fax | 859-341-0310
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1874LCSW
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1874
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License Number State | KY
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